Bio

Dr. Paul Friedman is a Professor of Medicine and Vice-Chair of the Department of Cardiovascular Medicine at Mayo Clinic, Rochester, Minnesota, and Vice-Chair for Academic Affairs and Faculty development. He is ABIM board certified in cardiovascular medicine and cardiac electrophysiology, and is an active participant in the MOC process.

Previously, Dr. Friedman served as Director of the Cardiac Implantable Device Lab, Mayo Clinic. He is a trained electrical engineer, with deep experience in innovation (> 40 patents issued, named Minnesota Top Inventor), and scientific research (> 250 scientific original publications). He is a committed educator, serving as a director for 5 national and international meetings, editor of 7 textbooks, and author of over 60 book chapters. He is a frequent visiting professor and lecturer at educational meetings. His research interests include advanced processing of physiologic signals for remote patient monitoring, development of novel devices for percutaneous cardiac procedures, and implantable electronic cardiac device development and clinical use.

Dr. Friedman received his BA in Plan II liberal arts and BS in Electrical Engineering from the University of Texas at Austin. He received his medical degree from Stanford University, and trained in internal medicine at the University of Washington, Seattle (internship) and Stanford University. He trained in cardiovascular medicine and cardiac electrophysiology at Mayo Clinic, Rochester, MN.

Abstract

The Development of a “Bloodless Bloodtest”:  A paradigm for bringing engineering to the bedside


Blood potassium levels are tightly homeostatically regulated, and critical for normal physiologic cellular function. Fluctuations in potassium values are found in many disease states and can expose patients to life threatening arrhythmias. Therefore, a convenient, non-invasive means of determining potassium values may decrease morbidity and mortality, and applied in the outpatient setting, shorten hospitalization and prevent readmission by safely permitting hospital discharge while monitoring for changes in potassium levels. We developed such a tool, which we labeled “bloodless blood tests.”

In order to address this pressing clinical need, we proposed the following concepts: 1) Small changes in plasma potassium are accompanied by quantifiable changes in the processed surface ECG; 2) Once an individualized baseline ECG is obtained for a known potassium value, subsequent changes in potassium can be determined noninvasively by measuring changes in the processed ECG; 3) Potassium related ECG changes can be used to track changes in potassium levels in the clinical context; 4) Following development of an individualized model, a global model may be created.

From inception to development and testing, this project will be presented as a paradigm of application of engineering principles to the bedside, and of the collaboration between engineers, physicians, and other experts to bring new technologies into clinical medicine to improve lives. With a commercial partner, regulatory approval to bring this technology to patients is underway.