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| EDITORIAL |
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| Year : 2022 | Volume
: 8
| Issue : 1 | Page : 19 |
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The impact of digital technologies on biological and biomedical engineering
David John Wortley
European Chapter, International Society of Digital Medicine, Alderton, United Kingdom
| Date of Submission | 30-Mar-2022 |
| Date of Decision | 26-Jun-2022 |
| Date of Acceptance | 27-Jun-2022 |
| Date of Web Publication | 29-Aug-2022 |
Correspondence Address:
David John Wortley
International Society of Digital Medicine, The Old Barn, Pury Road, Alderton NN12 7LN
United Kingdom
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/digm.digm_13_22
How to cite this article:
Wortley DJ. The impact of digital technologies on biological and biomedical engineering. Digit Med 2022;8:19 |
| Engineers and Engineering – A Historical Perspective | |  |
The engineering profession is one of humankind's oldest and most established scientific disciplines. The word Engineer is derived from the Latin words ingeniare (“to create, generate, contrive, and devise”) and ingenium (“cleverness”).[1] Although there are many different engineering disciplines, all engineers seek to design, create, and develop artifacts which contribute to the functioning and quality of human life. It could be argued that the engineering profession has been a major driver in the development of human civilization. Civil engineers design and build our roads, bridges, houses, and offices while mechanical engineers design and build machines to carry out tasks beyond the physical capability of humans and electrical engineers bring us heat and light.
Engineering is a scientific discipline which relies on an understanding of the physical properties and behaviors of elements, materials, and objects. This knowledge and understanding have been built up over thousands of years of research and practice and are critical to the reliable functioning, precision, and predictability of engineered products. The scale and ambition of engineering projects rely on our ability to observe, measure, analyze, and predict outcomes. Engineers translate this knowledge into the design and construction of new artifacts which shape the world we live in.
| The Challenge of Biological and Biomedical Engineering | | |
Working with inanimate objects with physical, nonbiological properties, and predictable behaviors is the bedrock of most engineering professions such as civil, mechanical, electrical, and chemical. Living organisms are far more complex and far less predictable in their behaviors which make bioengineering practices considerably more challenging and probably explain why medicine, life sciences, and biology were treated as a separate discipline from engineering topics in both education and professional career development for most of human history.
Prosthetics are an example of engineered artifacts which are designed to provide functioning replacements for missing or defective parts of living creatures. [Figure 1] shows the evolution of prosthetic limbs over history and is intended to illustrate the fact that early biomedical engineering created primitive separate attachments to the human body rather than devices which either effectively replaced part of the human body, duplicating its behaviors and functionality, or working in harmony with its biological processes to improve or augment their efficiency. | Figure 1: Antique prosthetic legs. Copyright NMHM (National Museum of Health and Medicine) in Washington DC.
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It is the complexity of living organisms and their behaviors which makes biological and biomedical engineering such a challenge. Since engineering as a profession does require an ability to design and construct artifacts which are reliable and as functional as possible, it is little wonder that the evolution of biological and biomedical engineering only really began with advances in our knowledge and understanding of the behaviors of living organisms.
| Biological Versus Biomedical Engineering | | |
While both biological and biomedical engineering involve a knowledge and understanding of living organisms and their behaviors and are often both referred to under the common term “Bioengineering”, I believe there are important significant distinctions between biological and biomedical engineering which are relevant to their role, importance and impact on the future of humanity.
In general, biological engineers attempt to either mimic biological systems to create products or to modify and control biological systems. Working with doctors, clinicians, and researchers, bioengineers use traditional engineering principles and techniques to address biological processes, including ways to replace, augment, sustain, or predict chemical and mechanical processes.[2],[3] This definition implies that biological engineering involves applications which either create organic material or modify the functions of living organisms.
Biomedical engineering, on the other hand, “seeks to close the gap between engineering and medicine, combining the design and problem-solving skills of engineering with medical biological sciences to advance health-care treatment, including diagnosis, monitoring, and therapy”.[4],[5] This distinction between biological engineering and biomedical engineering is a reflection of the view that biological engineering creates or shapes living organisms while biomedical engineering creates mechanical and/or electronic devices which interface with living organisms to assist with diagnostics, treatment, and therapeutics.
| The Impact of Digital Technologies | | |
The devices used by doctors and clinicians to monitor and record vital signs including thermometers, stethoscopes, and sphygmomanometers had changed very little over the decades before digital technologies began to evolve. These types of devices could be said to be the product of biomedical engineering along with prosthetics and mechanical ventilation devices. Digital technologies have acted as a catalyst for both biological and biomedical engineering advances.
Combined with sensor and scanning technologies, digital communication technologies have brought about a quantum leap in both our understanding of living organisms and our ability to analyze and support clinical diagnosis and treatment. Professor Shaoxiang Zhang, Founder of the International Society of Digital Medicine, has been a pioneer in the use of digital technologies to image the human body in precise detail within the China Visible Human project.[6]
[Figure 2] shows a graphical representation of the impact of digital technologies on medicine, health, and well-being. It reflects on the shift from proprietary, unconnected technologies specifically designed to address a medical challenge toward smart, connected devices with embedded generic technologies. An example of this would be the use of medical scanners and X-ray machines which previously relied on skilled radiologists to operate and interpret results. Today, developments in artificial intelligence (AI) and improvements in human-computer interfaces mean that less skills and training are necessary to achieve improved outcomes. | Figure 2: A subjective assessment of technology trends (copyright author).
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Digital technologies bring about greater precision, granularity, reliability, affordability, and communicability to the medical profession. Biomedical engineers are at the leading edge of applying these technologies to clinical diagnostics, treatments, and therapeutics. We have already entered an age where many digital consumer devices such as smartphones and wearable smartwatches are capable of monitoring and recording vital signs, offering preventative health-care advice, and delivering remote telemedicine support. These types of biomedical advances, which are often a product of multidisciplinary collaboration and commercialization, will help to make an important shift toward preventative health care and technology-enabled personal health management.
Digital technologies have also enabled biomedical engineers to develop devices which augment, support, and potentially replace living organs. The heart pacemaker became a technical possibility in the early days of transistors and today we are able to implant devices such as insulin pumps which are triggered by biomedical sensors. Biofeedback technologies are a critical resource for biomedical engineers because they facilitate the development of innovative new devices capable of monitoring and managing human health either automatically or in partnership with emerging digital health-care ecosystems.
The human genome project would not have been possible without advances in digital technologies and the computational power this brought about. These developments have led to significant advances in precision medicine and the development of new drugs and therapies that are targeted at biological characteristics and behaviors in the domain of biological engineering.
| Generic Digital Technologies and Innovations in Biomedical Engineering | | |
Innovations occur across boundaries when ideas and knowledge from one discipline can spawn new ideas and solutions in another discipline. [Figure 3]a and [Figure 3]b (Copyright Footfalls and Heartbeats) show examples of such innovative collaborations enabled by generic digital technologies. | Figure 3: Smart textiles. (a) Knitted shoe using smart textiles. (b) Customizable 3D printed prosthetic arm for young children. 3D: Three dimensional.
Click here to view |
[Figure 3]a shows how textile manufacturing engineers have been able to collaborate with biomedical engineers to design a knitted shoe with embedded sensors and Bluetooth technologies able to track gait and pressure when walking or running. This data, when used to visualize and simulate movement, can support trained physiotherapists in both diagnosis and treatment. Smart textiles with embedded sensors offer the potential for real-time medical use in the manufacture of many different types of garments, leading to the development of personalized clinical diagnostic solutions that can become “ambient” products that are an unobtrusive part of everyday life.
Three-dimensional (3D) printing is also a major growth area for innovative biomedical engineering devices. The pediatric prosthetic arm shown in [Figure 3]b is an example of enabling digital technologies being used to make a consumer-friendly and affordable prosthetic device. The prosthetic arm shown in [Figure 3]b is adjustable and can be personalized to young patients through the use of 3D printing. The prosthetic arm can be ordered over the Internet and manufactured in a matter of hours.
These are just two examples of ways in which generic digital technologies can act as a catalyst to innovation by a multi-disciplinary approach to a medical challenge. These technologies can help to break down the walls of silos of expertise which have traditionally acted as a barrier to lateral thinking.
| The Wider Implications of Generic Digital Technologies and Engineering | | |
The parallel universes of automotive and biological/biomedical engineering
To understand the wider and more profound implications of generic digital technologies it is worth considering how these technologies have impacted another engineering discipline with similar and/or analogous challenges.
Automotive engineers are tasked with designing and building vehicles which are safe, reliable, affordable, attractive, and capable of transporting their owners from destination to destination with the minimum amount of effort and maintenance. To achieve this goal, they incorporate into their design features to support their human users as well as those responsible for maintaining the vehicle.
[Figure 4]a and [Figure 4]b (Copyright Creative Commons) is intended to illustrate the impact of generic digital technologies on automotive design and functionality. [Figure 4]a shows the dashboard of a vintage car and the information available to the driver in the early 20th century. Each vehicle manufactured in those days before precision engineering had its own “personality” and characteristics which required human skills and experience to both drive and maintain the vehicle. [Figure 4]b shows the kind of dashboard available today in vehicles which are autonomous, precision engineered, and reliable and require minimal human skills to operate and maintain. | Figure 4: Car dashboards. (a) Vintage car dashboard. (b) Autonomous car of future dashboard.
Click here to view |
In the design and manufacturing process, digital technologies have become an essential part of automotive engineering. These technologies help engineers to understand the characteristics of the components that make up a vehicle. They can model and simulate the look and performance of vehicles before manufacturing and they can also build in self-diagnostics and even self-repair capabilities all of which make the design and manufacturing cycle much quicker, more responsive to change, and less risky.
Clearly, one of the major differences between automotive and biological/biomedical engineering is that cars are made of nonbiological components with predictable and stable properties, whereas human beings use biological, living components and are infinitely more complex in the way they function and behave.
However, if we consider that the human body is like a vehicle which transports each of us on our journey through life, we can draw parallels between developments in automotive engineering and their digital opportunities and challenges and the likely impact of digital technologies on biological/biomedical engineering.
[Figure 5] (Copyright Creative Commons) shows how wearable devices are able to monitor vital signs and key health parameters in real time to provide doctors and clinicians with precise diagnostic tools. However, they also use AI to help users to better understand and manage their personal health without the need for a clinician.
In the use of digital technologies to develop these devices, biological/biomedical engineers are effectively creating a health equivalent of a car navigation system whereby users can choose a target health destination and be provided with personalized advice on the best route to that destination. Just as modern in-car technologies help drivers to navigate between destinations without the support of human experts, these technologies have the potential to transform preventative health care by empowering individuals to better care for themselves.
However, if we extend the analogy to modern-day autonomous vehicles, the eventual outcome for biological and biomedical engineers is the design of solutions that take over the monitoring and control of human biological functions. An embedded insulin pump might be a good example of how a clinical challenge could be solved this way.
| Biomedical Engineering, Longevity, and Humanity | | |
Building on this interpretation of the impact of digital technologies on the monitoring and maintenance of our bodies, we can argue that we are entering new territory in which human longevity and capabilities are extended and enhanced by bionic devices, creating the potential for what science fiction writers call “Cyborgs”. These so-far fictional hybrid creatures which combine biology and technology could become a practical reality over the next few decades, raising the possibility of longer lifespans and the potential erosion of what it means to be human.
A concept known as “Singularity”, defined as “a hypothetical moment in time when AI and other technologies have become so advanced that humanity undergoes a dramatic and irreversible change”, is seen by some people as a reference to humans evolving into cyborgs.
The futurologist Ray Kurzweil described the Singularity[7] as a crucial time point when AI will have achieved human levels of intelligence. He envisaged a merging of human and AI connected by cloud computing. In his book “The Singularity is Near”, Kurzweil said that revolutions in genetics, nanotechnology, and robotics will usher at the beginning of the Singularity.[8] Kurzweil feels with sufficient genetic technology it should be possible to maintain the body indefinitely, reversing aging while curing cancer, heart disease, and other illnesses.[8]
This suggests that, in future, it might not only be possible to extend lifespans indefinitely but also that it might also be possible for an individual human being's intelligence to exist without the need for a physical body. Not only does this present a major challenge/disruption to digital medicine and medical practices but also some serious ethical issues.
| The Opportunities and Challenges of Biological and Biomedical Engineering | | |
Some key conclusions
The rapid evolution of a broad spectrum of consumer digital technologies designed for nonmedical applications has created a range of opportunities and challenges for biological and biomedical engineers. On the positive side, the Internet of things (IoT) connected sensor devices linked to smartphones and high-speed 5G networks have made medical monitoring and diagnosis faster and more accurate. On the negative side, these advances present problems for clinical validation and management because they generate data which is personal and sensitive and open to misinterpretation and/or abuse.
Advances in both biological and biomedical engineering have already had a significant impact on human life. These advances have made it possible to respond more rapidly to pandemics, develop precision medicine practices, save and/or extend lives, and improve the quality of life for thousands of people with defects in the functioning of their bodies.
As with other scientific advances, the impact of digital technologies on biomedical and biological engineering has created multiple potentially disruptive opportunities and challenges for humanity. In the field of biological engineering, advances in genetic engineering have led to precision medicine, and most recently, to the genetic modification of a pig's heart[9] for successful transplant into a human being. Lives can be saved and quality of life can be enhanced by such developments without detracting from our humanity.
Conversely, digital technologies applied to biological and biomedical engineering also have the potential to enhance and augment our human capabilities by taking over and improving our physical and mental functions with serious implications for our humanity.
In summary, the generic digital technologies of wireless networks, IoT, AI, big data analytics, cloud computing and interactive, immersive simulations, and visualizations are most likely to lead to:
- Faster, more powerful, and intuitive tools for biological/biomedical engineers to develop solution to today's challenges.
- Higher levels of innovation and multi-disciplinary collaboration between industry, research, and academia.
- Transformative and disruptive changes to health-care ecosystems and job roles and responsibilities.
- A determining and critical influence on future of humanity.
Future lies in our hands and biological and biomedical engineers will play a critical role in that future.
Financial support and sponsorship
Nil.
Conflicts of interest
David John Wortley is an Editorial Board Member of the journal. The article was subject to the journal's standard procedures, with peer review handled independently of this editor and his research groups.
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| 2. | Pasotti L, Zucca S. Advances and computational tools towards predictable design in biological engineering. Comput Math Methods Med 2014;2014:369681.  |
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| 4. | Enderle JD, Bronzino JD. Introduction to Biomedical Engineering. Amsterdam: Academic Press; 2012. p. 16. |
| 5. | Fakhrullin R, Lvov Y, editors. Cell Surface Engineering. Cambridge: Royal Society of Chemistry; 2014. |
| 6. | |
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| 8. | Kurzweil R. The Singularity is Near. London: Viking Books; 2006. p. 205. |
| 9. | |
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]
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