Technology in medicine is hardly new, having aided the diagnosis of disease and care of human bodies for at least two centuries (see 1815: the invention of the stethoscope). But the pace of change has quickened, as the advances of the past twenty years—artificial intelligence, robotics, machine learning, 3D printing—infiltrate hospitals and operating theaters, drug research and assistive devices.

Of course, trusting a robot to perform delicate surgery is a far cry from asking it to vacuum your floor. And asking an algorithm to analyze insurance claims has lower stakes than asking it to devise a treatment strategy for chronic diseases or aggressive cancers. Moreover, innovators can’t focus only on garnering funding and sparking consumer demand: they must also contend with a robust regulatory system governing healthcare and the daunting awareness that mistakes could cost lives.

Yet pioneers continue to wield technology in ways that reduce medical error, improve treatment or therapeutic options, or wrangle massive quantities of data to illuminate hidden meanings. Three of those pioneers call Newlab home: Monogram Orthopaedics, which has been refining a revolutionary approach to joint implant surgery; 10xBeta, which has developed a number of innovative medical devices in collaboration with doctors and caregivers; and OccamzRazor, an AI-neuroscience startup that uses machine learning to help cure complex disease.

Multiple technologies infuse Monogram Orthopaedics’s approach: a combination of artificial intelligence, additive manufacturing, and robotics that enhance and improve joint replacement surgeries. Traditional hip replacement surgery requires surgeons to estimate the size and placement of implants from an Xray, choose from a range of pre-made implants, then manually create a cavity in the bone where the implants fit. The results can be inexact—at least 20% of patients are left with uneven legs, while around 5% experience femoral fracture or loosening of the implant.

Monogram—launched in 2017 by orthopedic surgeon Douglas Unis and engineering leads Sulaiman Somani and Matt DiCicco—takes a two-fold approach to creating greater accuracy of fit and placement. The company first uses a CT scan to create a 3D model of the patient’s hip joint (the surgery requires two implants, where the pelvis and femur articulate).

From this model, Monogram designs implants that match the patient’s bone mechanics and geometries; the surgeon can add input (such as soft tissue tension) before the 3D-printed implants are delivered to the hospital. Monogram uses an algorithm to create the custom implants at scale, allowing them to tackle a high-volume surgical market—at least 300,000 hip replacement surgeries are performed in the United States each year.

Monogram Orthopaedics is refining a revolutionary approach to joint implant surgery. Launched in 2017 by orthopedic surgeon Douglas Unis and engineering leads Sulaiman Somani (seen here at right) and Matt DiCicco, Monogram takes a two-fold, high-tech approach to creating greater accuracy of fit and placement.

Once in the operating theater, the surgeon is assisted by a robot that fits the implants precisely into the bone. “Having a high-quality 3D printout doesn’t mean anything unless you can get the exact shape cavity in the bone during the surgery,” DiCicco points out.

“We’re excited about using technology to produce outcomes that are far superior to what we have now,” DiCicco adds. That means both reducing complications and “ensuring quality of life,” says co-founder Somani, not just by eliminating pain but also restoring function. “They can go back to playing sports.” And hip replacements are just the beginning: the technology will eventually transfer to other areas, like shoulders and knees.

At 10xBeta, deep research and endless experimentation are the constants in an output that includes such disparate products as a sensor system to improve in-hospital care and a portable kit for first responders in the aftermath of a mass casualty incident. “One of the most complex parts of our job is that we do not have domain expertise in the clinical application of the products we design,” says founder and CEO Marcel Botha.

“But we have a very deep understanding of development, the need, and how it is supposed to work, and we spend a lot of time educating our team as to why and what the patient needs.” Botha continues: “The lack in domain expertise is further augmented by a strong relationship with clinicians, nurses and caregivers of all specialties, and backgrounds.”

10xBeta’s IndieGo mobility device.

Botha estimates that over 50% of the firm’s work is focused on medical products, some of which come through the JeffSolves initiative, a partnership with Philadelphia’s Thomas Jefferson University to turn novel ideas from medical students into reality. The program, now in its third year, has resulted in five viable products, including Validose, a device that securely measures customized, controlled dosages of medication while mitigating the risk of drug dependency.

Another product in 10xBeta’s pipeline is IndieGo, a mobility device that converts a manual wheelchair into an electric one. Botha sees it as an early entrant into what he predicts will be a major sector in medical innovation: personal mobility augmentation. “The way we design products will change as we see more and more users with multiple ability levels able to participate in things they never could before,” he says.

The explosion of connected devices in everyday life offers another avenue for innovation, says Botha. The proliferation of these devices, along with the miniaturization of sensors, will allow the collection and analysis of streams of data, which could then be turned to design customized care for patients in recovery from surgery or managing a chronic condition, such as diabetes.

A different kind of data stream informs OccamzRazor, which uses advanced machine learning to comb through biomedical data for insights into complex, multi-faceted diseases. The company currently focuses on Parkinson’s Disease (with support from the Michael J. Fox Foundation), with a vision toward applying their technology against other diseases in the near future.

The AI-driven process first aggregates the vast quantity of high-quality research produced in biomedicine (publications, clinical, patient reports, and more), and then identifies disease-causing pathways to target with curative treatment, says founder and CEO Katharina Volz. The aim is to streamline the discovery process for potential cures. “Typical approaches target only a single disease mechanism, which is not sufficient,” explains Volz. The aim of Occamzrazor’s AI-driven process is to streamline the discovery process for potential cures. “Typical approaches target only a single disease mechanism, which is not sufficient,” explains the company’s founder and CEO Katharina Volz.

Yet slowdowns still exist—mostly around meeting rigorous testing and FDA standards. But negotiating these waters is possible. One strategy is to chart out innovation along routes with an easier path to approval: “We try to limit our work to a multi-month rather than a multi-year process,” says Botha. Another tactic, as Somani and DiCicco note, is to take advantage of the 510(k) clearance, demonstrating that your device is “substantially equivalent” to one already on the market. “We can use proven technologies in new ways, which makes the approval process quicker,” says DiCicco.

Of course, safety is paramount, as is the potential to profoundly improve lives. Curing disease, restoring pain-free movement, using devices and data to better administer care and mobility: some things are worth the wait.

Photography by Minu Han This article was originally published in Tech Fancy Issue 9: Medicine Meta-Scene.