What do rockets, submarines and autonomous vehicles have in common with helping people to walk after a stroke? Professor Derek O’Keefe – the brains behind delivering diabetes medication by drone.
Professor Derek O’Keefe has had quite a career, from studying engineering in his native Ireland to becoming a physician in the US, working with the International Space Station and looking after people living at the bottom of the ocean.
Now he’s back in Ireland, and has just completed the world’s first delivery of diabetes medicine by drone.
We caught up with him to learn about the enduring pull of new technology, and the need for better drone regulation to help people with chronic illnesses.
How does an electrical engineer end up treating people?
As part of my final year project at the University of Limerick, I was given the challenge of how to help some patients to regain a normal walking pattern after a stroke. I continued working on this project through my Masters and PhD.
The electrical stimulation technology we developed had applications for astronauts who returned from long duration space flight operations, where there is muscle atrophy.
I was invited to Moscow to contribute to a space medicine workshop, and from there was asked to present my work at MIT.
After that, I was invited to do a postdoc at Harvard, working with highly motivated people, some of whom had dual training in engineering and medicine.
They encouraged me to go to medical school to get 360 degree insight into the role of medical technology in improving patient care.
So I sold all my possessions, took out a loan, and enrolled at the National University of Ireland. I completed my medical undergraduate and postgraduate training between Ireland and the United States, and graduated as an Endocrinologist.
When did you work with Nasa?
In 2006, a major physiological issue was ensuring that astronauts were getting adequate sleep.
Astronauts experience 16 sunrises/sunsets a day in orbit, and it interferes with their circadian rhythm – it’s like bad jet lag which can affect their work performance.
Measuring objective sleep data in zero gravity is difficult. My colleague (Dr. Marc O’Griofa) and I proposed a novel heart rate variability method to detect sleep stages using an integrated biovest.
The European Space Agency liked the idea, and awarded us an experiment space flight opportunity.
The Russian Space Agency transported our experiment to space. Then NASA returned our equipment to earth on the Discovery Space Shuttle. We were invited to Kennedy space centre to witness the shuttle landing, which was a great experience.
What did do you do to top that job?
Our space flight mission was a success, so we continued developing solutions to interesting space problems.
For example, the Martian day is longer than on Earth, and we wanted to understand how that would affect human physiology.
We carried out an experiment in the high Arctic, where there are habitats that can mimic Martian bases because of 24 hour sunlight.
How did you move from that project to working in an underwater environment?
In 2016, I got a call from the Nasa Extreme Environment Mission Operations (NEEMO) team.
They maintain the Aquarius habitat, an underwater laboratory submerged 20 metres below the Florida Keys, where astronauts and scientists can live for weeks at a time in an environment simulating space.
My role as flight surgeon was to monitor the aquanaut telemedicine data, and to use that data to inform operational decisions.
And finally you returned to a medical role in Ireland.
Yes. I was appointed as a consultant endocrinologist at University Hospital Galway and professor of medical device technology at the National University of Ireland Galway in 2018.
My remit includes direct patient care as a physician, and the development of innovative medical technology to improve outcomes.
What made you want to use drones to deliver diabetes medicine?
After Storm Ophelia (rain) and Storm Emma (snow), I was faced with the real clinical problem that my patients couldn’t attend their diabetes clinic.
Patients were understandably concerned about running low on insulin. Our management strategy was to hope that the weather would improve.
Thankfully, the weather did improve, but what would have happened if it didn’t?
I started to read about drone technology, and the aviation regulations governing them, and the transport of medications in Europe.
The current state of the art is called autonomous Beyond Visual Line of Sight (BVLOS), meaning you can operate your drone without having a direct view of it. Understandably, there is significant regulation around BVLOS drones, medication delivery, and blood sample transportation and hence the combination hasn’t been done.
Was this the first time someone has thought of delivering medicine by drone?
No, as the technology has improved and got less expensive, we are starting to see practical drone applications.
For example, Zipline has been delivering blood in Africa, and other companies have been delivering vaccines in the South Pacific.
One of the major challenges however with regular drone operations, especially in the western world, is airspace regulation, which is crucial for safety.
We have all seen in the news the problems when inexperienced drone operators do not obey the law, and cause havoc at places like airports.
The other challenge is that there is a lot of media hype around drones that overpromises what is currently possible.
The classic example has been the idea that pizza could currently be delivered by drone to your front door in an urban environment. It would too dangerous and is against the law in most countries.
What’s your message for the authorities?
It’s important to practice for emergencies before they happen.
We spent a year going through all the possible scenarios and risks involved in this #DiabetesDrone project, and developed answers to potential problems before they occurred.
The Irish Aviation Authority was very supportive of our mission – ensuring that the diabetes medicine was delivered and blood sample returned during a gap in scheduled commercial flights, while obeying all the aviation regulations.
Going forward, we will start to see an expansion of drone BVLOS operations, initially in emergency situations, and then for routine remote deliveries.
There now needs to be serious investment of time and money by governments and regulators in enabling drones, because they can make a significant improvement to the healthcare services provided to people living in rural communities.
Want to know more about the drone used in the delivery? Read our interview with SkyTango founder Steve Flynn about the technology behind this type of delivery, and the need robust regulation.
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