Bijan Najafi: Developing Technologies that Improve Stability, Healing, and Mobility Worldwide

With the goal of harnessing the untapped potential of Iranian-Americans, and to build the capacity of the Iranian diaspora in effecting positive change in the U.S. and around the world, the Iranian Americans’ Contributions Project (IACP) has launched a series of interviews that explore the personal and professional backgrounds of prominent Iranian-Americans who have made seminal contributions to their fields of endeavour. We examine lives and journeys that have led to significant achievements in the worlds of science, technology, finance, medicine, law, the arts and numerous other endeavors. Our latest interviewee is Dr. Bijan Najafi.
Dr. Bijan Najafi is currently serving with the Baylor College of Medicine, Michael E. DeBakey Department of Surgery as a tenured Professor and Director of Clinical Research in the Division of Vascular Surgery and Endovascular Therapy and Director of Interdisciplinary Consortium on Advanced Motion Performance (iCAMP). He is also serving as an adjunct Professor at the School of Engineering, Rice University, Houston, TX and Adjunct Professor at the Colleges of Engineering and Medicine, University of Arizona, Tucson, Az. He completed his Ph.D. in Bioengineering followed by a Postdoctoral Fellowship in Applied Biomechanics at the Swiss Federal Institute of Tech (Lausanne, Switzerland), and in Neuroscience at Harvard University, Neuromotor Control Lab.
He has over two decades of experience in designing bio-inspired sensors for objective evaluation of healthy state of patients with locomotor dysfunctions, over 200 scientific publications in peer reviewed journals or conference proceeding with more than 7500 citations, 20+ issued/pending/provisional patents, and have been PI or a key investigator on over 50 industrial, national and international grants ($50M+). He worked with a wide network of clinical and bioengineering collaborators across the globe primarily in the clinical areas of falls, frailty, gait, cognitive-motor, ergonomic/posture, dementia, and diabetes and diabetic foot ulcers.
His unique expertise is the translation of wearable technologies for more accurate movement assessment of patients in their natural environment where they’re the most comfortable and active. His goal is to better understand how people move through their environment. In this way, he believes we may be able to fundamentally change the way we objectively measure quality of life for people across disciplines. He has assisted in successful translation of several innovative technologies for commercialization in the area of remote heath monitoring, precision medicine, and movement assessment including several wearable and mHealth technologies for activities monitoring, gait analysis, balance assessment, automatic fall detection, patient adherence, surgical skills/ergonomics, and various technologies for foot problems management including prevention of diabetic foot ulcers. Thanks to his contribution in translations of innovation from engineering to various clinical applications, he has been awarded as one of the Influential Health and Medical Leaders in the category of achievement in medical devices by Tucson Local Media.
He has mentored over 500 postdoctoral, research fellows/interns, graduate, undergraduate, premed, and medical students — several of them received prestigious awards from their achievements while working in his team. He also serves as editor, associate editor, and guest editor for several scientific journals including as a section editor for Gerontology, ‘Regenerative and Technological Section’ and Journal of Diabetes Science and Technology.
Tell our readers where you grew up and walk us through your background. How did your family and surroundings influence you in your formative years?
My career has focused on developing technologies that improve stability, healing, and mobility worldwide through research and the mentoring of young scientists and engineers by clinical and industrial partners.
I was born in Isfahan on 1972. After finishing Harati High School, I attended Isfahan University of Technology from 1990–1994, where I graduated with a Bachelor of Science Degree. I majored in Electrical Engineering and Computer Science and in 1994 was awarded as the First Rank of my Class.
I completed my Ph.D. in bioengineering followed by a Postdoctoral Fellowship in biomechanics at the Swiss Federal Institute of Tech (Lausanne, Switzerland) and in neuroscience at Harvard University. Currently, I am serving with the Department of Surgery at Baylor College of Medicine (Houston, Texas) as a tenured Professor, Director of Clinical Research in the Division of Vascular Surgery, and Director of Interdisciplinary Consortium on Advanced Motion Performance (iCAMP). I hold also an Adjunct Professor appointment with Rice University. Prior to my appointment at Baylor College of Medicine, I served as an Associate Professor at the Rosalind Franklin University in Chicago, a tenured Professor in the Department of Surgery at the University of Arizona, chair of research operation at the Southern Arizona Limb Salvage Alliance (SALSA), member of the Arizona Center on Aging, Member of the Arizona Cancer Center, and scientific advisory board member of the Arizona Arthritis Center.
What has been your personal key to success? What were the biggest inspirations for your career?
I always appreciate collaboration with other disciplines, which I believe was my personal key to success. When I was a graduate student, I was involved in a national project in collaboration with Swiss TeleAlarm to design a wearable device in the form of a pendant that automatically detected falls in older adults and promoted aging in pace. I spent the first six months developing an algorithm to detect falls and monitor daily physical activities such as walking, sitting, standing, and lying down on the bed. To validate my method, I started with simulating falls and normal daily physical activities by recording some of my young classmates and students who volunteered to assist with my project. This was in 1998 — long before Fitbit and other wearable gadgets now widely used for activity tracking were on the market. nly after meeting a geriatrician, named Dr. François Leow at the University of Geneva, did I gain a better understanding of true clinical unmet needs in the field of elderly care and subsequently realize that all my initial experiments were almost useless as they did not replicate real-world scenarios including the physical activity patterns of older adults. Thanks to meeting Dr. Loew, I obtained the opportunity to appreciate the true needs of older adults by observing the activity pattern of geriatric patients at a hospital in Geneva-Switzerland. I then expanded my interdisciplinary collaboration with other geriatric hospitals in Lausanne, ULM (Germany), Stuttgart (Germany), and Saint-Etienne (France), which helped my research career flourish. In this time, I became a pioneer in designing wearable medical devices. Through these fruitful experiences, I told myself that if I decided to stay in academia, I needed my primary appointment to be in a college of medicine instead of engineering. I am so grateful that since 2008, I had always secured my academic primary appointment with a college of medicine. This was key to the successful commercialization of innovative medical devices. From here, unmet medical needs such as limb amputation of people with diabetes, the prevention of falls in older adults, and telemedicine and telehealth for remote management of chronic illness could all become addressed in the general market
Can tell us what your area of expertise is and what your interests are? Can you share some specific highlights of your work?
Early in my career at the Swiss Federal Institute of Technology, I developed a deep appreciation for the need to create better scientific methods in order to assess mobility out of laboratory and improve patients’ central role in enabling an optimized health care ecosystem.
I have a broad background in bioengineering with specific training and expertise in biomechanics, wearables, digital health, telehealth, frailty, outcomes research, and rehabilitation. Over the past 20 years, my colleagues and I have created several models, methods, and “smart” wearable technologies that enable objective monitoring of cognitive-motor, remote monitoring of frailty, cognitive function, and risk of falling. We’ve established new techniques that have shown enormous promise in preventing limb and life-threatening gangrene as well as providing early-warnings to prevent life-threatening falls and fractures in older adults. These “game changing” technologies are actually “game-based” in that they allow the wearers to improve their stability and mobility through novel video-game-like therapies. In addition to our local research initiatives, I partner with a host of businesses, analysts, and research teams worldwide to foster advances in the field of motion performance. Due to my contribution of technologies that are able to translate into various clinical applications, I was recognized as one of the most Influential Health and Medical Leaders by Tucson Local Media in 2014.
I have published over 200 scientific articles in peer-reviewed journals and conference proceedings with more than 7400+ citations, 20+ issued, pending, or provisional patents, and I have been PI or a key investigator of over 60 industrial, national and international grants ($50M+). I am a Professor (with Tenure) with Baylor College of Medicine, Michael E. DeBakey Department of Surgery (Houston, Texas); Director of Clinical research at the Division of Vascular Surgery and Endovascular Therapy; and Director of the Interdisciplinary Consortium for Advanced Motion Performance (iCAMP). I had the opportunity to mentor 350+ postdoc, research fellows/interns, graduate, undergraduate, premed, and medical students; several of whom received prestigious awards for their achievements while working on my team. I also serve as Editor, Associate Editor, and guest editors for several scientific journals including Section Editor for Gerontology, ‘Technological Section’.
What is the biggest obstacle you’ve faced along your career path? How did you overcome this?
Marketing my scientific idea and obtaining ability to write a scientific paper were my biggest obstacles early in my career. In Iranian Universities, we are rarely taught how to write a scientific grant proposal or give a lecture that could be comprehended by people who are not experts in our field. Even when I was in Switzerland, I didn’t learn to market my new ideas to secure research funding and build successful partnerships with industries. My poor English writing skills limited my ability to disseminate the results of my scientific efforts. I only recognized these weaknesses when I had the opportunity to be a postdoc at Harvard University. During our extensive lab meetings, which took sometimes over 4 hours, we had the opportunity to practice how to market our research. I was highly challenged by myr lab mates and learned how to scientifically defend my arguments and approaches. Comparing my skill of writing and presentation with my other lab mates in Harvard was very depressing. I never had such a feeling before, even in Switzerland, where I thought myself a successful researcher and lecturer. To overcome this limitation, I tried to read as much scientific literature published in top journals as I could, and challenged myself to improve my writing, ask my lab mate to edit my writing, and try to and present regularly during our lab meetings. I admit this wasn’t an easy undertaking and took several years before I finally felt more confident in my writing and ability to present scientific information.
What project or research are you the proudest of?
I was very lucky that early in my career I became familiar with wearable technologies and the concept of “digital health.” This was long before the development of smartphones and smart watches. But probably, the most important landmark in my work was the successful design of a technology that accurately monitors physical activities, predicts falls of the elderly, and the automatic detection of those falls. My fall detection algorithm has now been integrated in many Personal Emergency Response Systems (PERS) in the US market. My algorithm has contributed to the salvation of many lives by providing timely emergency care to those who fell in their home while alone. I am also proud that some of the technologies that we have developed now have successfully transferred to the market to prevent limb amputation in people with diabetes. In some of our research, for example, we have shown that a smart mat — a bath mat that can be placed in the patient’s bathroom or next to their bed — can predict a foot ulcer with a lead time of 37 days, and an accuracy of 97% by checking foot temperature. I am hoping to continue these collaborative efforts to assist with the introduction of innovations in engineering to the medical field to address various clinical unmet needs. I hope that these innovations can help improve the quality of life of our patients who are suffering from chronic illnesses such as diabetes, cancer, cardiovascular problems, and dementia.
In your view, what is the biggest challenge with which your field is currently grappling?
The economic burden of our aging population is daunting, largely driven by the need for long-term care. The increase in chronic conditions with aging is financially and emotionally costly to patients, families, and society. The most common conditions such as diabetes, cancer, cardiovascular and respiratory diseases, and mental illness demand immediate and creative action to provide solutions for managing the physical, social, and psychological needs with the goal of maintaining autonomy and quality of life. Though more individuals are dying of chronic conditions than of acute diseases associated with disasters, trauma, or infection, relatively little research has attended to the long-term functioning of those with chronic illnesses. Maintaining autonomy and remaining at home, called “aging in place” is consistently one of the highest priorities for older adults.
These problems plaguing the U.S. healthcare system beg the question: “Is it possible to achieve better outcomes for patients, e.g., aging, chronically-ill, and/or comorbid, at a lower cost?” We desperately need creative solutions to facilitate the management of chronic diseases “in-place” as an alternative to repeated hospitalization and long-term care. We should also empower patients and their families and promote their central role and responsibility in enabling an optimized healthcare ecosystem.
How do you see your field changing? What excites you most about the future of your field?
Enterprises are increasingly interested in intelligent telemedicine, the backbone of a new market, i.e., “digital wellness,” which combines digital technology and healthcare. Digital technology-based healthcare is regarded as a natural and ultimate choice for outpatient settings due to its low cost, high accuracy, and continuous monitoring and tracking capabilities. In particular, recent developments in the area of “digital health” and “digital wellness” are promising for the enabling and promoting of aging in place, personalized medicine, precision environmental health, and smart management of chronic and non-communicable diseases. These developments include telecommunication, data mining and analysis, and comprehensive feedback.
You hold several U.S. patents. Can you tell us which ones have been your greatest achievements?
Four of my issued patents were relatively successful and became integrated in several commercially available products and were used in many clinical and pharmaceutical trials including fall detection, activity monitoring using telehealth, gait (the characteristics of the way we walk) assessment using wearables, and assessment of frailty for pre-operative decision making of adverse outcomes.
Is there anything you would have done differently looking back at your career path?
After graduation, I stayed in Switzerland as a lecturer and a research scientist for almost 4 years. During this time, I declined several interesting postdoc positions in highly ranked U.S. institutions like Berkley, Stanford, and the University of Illinois. I asked myself why I would move somewhere else when I already had a permanent academic position. I thought to myself that it was much easier to stay in the same location, where I already knew the environment and had good friends and colleagues. However, I neglected to consider the fact that I was not yet an independent researcher and still under the shadow of somebody else. In addition, I soon realized that remaining in the same institution limited my opportunity to get a promotion and improve my career. While I admit this period was productive and very fun, I now realize that one more year at the same institution that I graduated from would have caused me to miss the opportunity to become an independent researcher! My recommendation to other young graduate students is to never waste your time with a postdoc position in the same institution and to, as soon as you can, move to another institution or join the industry. In particular, note that the ideal period of time spent as a postdoc or non-independent researcher is less than three years, and after 5 years many doors will be closed in the industry and academic settings.
Can you share your thoughts on your Iranian-American identity? What does it mean to be an Iranian-American to you?
To be the first-generation immigrant is always a difficult role and is challenging no matter the nationality. At the same time, I find that sharing good memories with friends who share the same culture and language is always fun. I was very lucky that, no matter where I moved, I found some good Iranian friends who assisted me in smoothly settling down in my new location and connecting me to good people for both social and professional networking. I believe we are lucky to have the opportunity to learn multiple languages and become familiar with several cultures, as it enables us to easily settle down in a new location and better network with people with diverse backgrounds and cultures. The key is to leverage these assets in order to become a successful and respectful member of society.
