USF Graduate Creates a Healing Combination

Alicia Billington’s work offers  healing solutions for patients living with limited mobility.



Video by Katy Hennig | USF News


By Katy Hennig

     USF News


TAMPA, Fla. (June 24, 2014) - By calculating movement and combining two different fields of research, Alicia Billington, M.D., is changing the way health care professionals diagnose and treat pressure sores—a common medical problem that affects millions of people each year.


“I think that a lot of the processes that we do in medicine can be optimized through engineering,” says Billington.


Billington is the first USF student to graduate with a dual M.D./Ph.D. degree in engineering, combining the two related but disparate disciplines of medicine and engineering. She is poised to become a leader for the next generation of physician scientists.


“It’s not easy,” says Dr. Peter Fabri, the academic adviser who co-designed Billington’s dual discipline research track along with William Lee, III. He describes the path as an integral connection between medicine and innovation, adding, “the shared skills and talents enrich medicine.”


Incorporating problem-solving skills from her background in biomedical engineering, Billington has invented a new method for analyzing how people move, which she is hoping one day could prevent pressure sores. The sores, commonly called bedsores, are injuries to the skin and underlying tissue that can result from pressure on the skin and muscles. They can occur in nursing home patients, who may lie in bed or remain seated for long periods of time and they may also plague patients of all ages who experience limited mobility, such as veterans in wheelchairs.


“Alicia developed the ability to analyze massive amounts of data and reduce it into very simple concepts so you can actually track how people move as they sit in a chair,” says Fabri. “The real engineering accomplishment that she has made is developing a new approach for analyzing this type of data.”


Billington’s research has generated an algorithm to examine areas of high pressure in patients with varying levels of paralysis. According to Billington, there is an absence of information about how and why the sores, which can be extremely difficult to treat, form and become infected.


“There have been quite a few studies, and it is very hard to pinpoint the exact cause of the pressure sore. The word ‘pressure’ makes you think it’s pressure, but there are so many different confounding variables that it’s hard to figure out what causes it and how to cure it,” explains Billington.


Ultimately, the goal is to provide treatment in advance of the symptoms by monitoring a patient’s movement and calculating the amount of pressure through that movement.



Alicia Billington demonstrates the mapping technology that she uses for measuring pressure.                                  Photo by Katy Hennig | USF News

 


Using an existing Xsensor mapping product—a 36-inch by 36-inch square grid that looks similar to a checkerboard and has a sensor in each square—Billington collects data about a patient’s movement and pressure areas. She feeds the data into an Excel spreadsheet and then, using a computer program she designed, produces two hemi-ellipsoid shapes that move over time to help predict where the sores may form.


Billington’s statistical approach to diagnosis allows physicians to understand how a person with full mobility moves when they are seated and compare that data to a paraplegic’s movement. This information could allow for the development of pressure relief techniques to mimic individuals who are fully mobile and could lead to new protocols to help prevent pressure sores from forming.


“If we can figure out how a person can adjust themself to prevent these sores, that is going to change their life,” Billington says.


Surgery to fix the sores is complex and involves specialized techniques such as creating a flap by rotating skin and muscle with a blood flow to close the wound. Billington’s research in plastic surgery will advance treatment options and offer hope for new methodologies.


“We often treat patients with pressure sores by rotating skin and muscle to help cover the wounds, which can allow them to go from being bed-bound to being able to move around in a wheelchair again,” Billington says.


In the future, Billington’s innovative algorithm and mapping technology could help to monitor movement and detect the problematic sores before they form.


Billington’s mission to improve patient care has grown out of a deep understanding of both medicine and engineering. Her new approach using analytical and mathematical techniques allows for research breakthroughs.


“I think that math has always been a true passion of mine. It’s something that I really enjoy; it makes me really happy,” says Billington. “The possibility of combining that with my love of medicine is something that I couldn’t turn down—taking patients and helping them get better through engineering.”


Though Billington always wanted to practice medicine, she initially followed her passion for solving mathematical equations to earn bachelor’s and master’s degrees in biomedical engineering from Cornell University. She then decided to return home to the Tampa Bay area and enrolled at the USF Health Morsani College of Medicine.


“Of course I want to help people, but you can help people in a variety of different ways. My dad is a police officer; he helps people. My mom is a teacher; she helps people,” Billington says.


“But I think the reason that I was so drawn to medicine is because the human body is very much like a machine, just like in engineering. I was drawn to the mathematics of medicine and I think that there is a lot related between the two fields.”



Billington celebrates on match day with U.S. Rep. Kathy Castor.                                                                       Photo by Eric Younghans | USF Health



In the spring, just before receiving her medical degree, Billington was selected for residency at the USF Health Morsani College of Medicine. The match was ideal, allowing her to continue her research in the plastic surgery field and develop healing techniques.


“One of the things that I really like about plastic surgery is that it’s tangible; you can see your work immediately. It’s the only area of surgery where you get to see your results,” Billington says. She sees incredible potential in the reconstructive aspect of treating pressure sores.


“I think that the majority of what you spend your time doing in the third year of medical school is problem solving, and that goes hand in hand with what an engineer does. You approach a problem—you try to figure out all of the parameters involved and different solutions. Sometimes it’s not the easiest path; you have to think outside the box. To me, the two fields blend together very nicely.”


Billington will be in residency for the next six years, continuing her research and work with pressure sores as she rotates through five Bay Area hospitals.


Billington’s leadership is not limited to her groundbreaking research. In 2012, she received the Leadership Award for Excellence in Medicine from the American Medical Association for her work on graduate medical education advocacy. She was one of only 30 students, medical residents, fellows and young physicians across the country to receive the honor.


Billington was also president and vice president of the USF Medical Student Council and created the “Leadership in Medicine Lecture Series,” bringing notable speakers to campus—including the Florida Surgeon General.



Billington advocates on the amount of student residency programs in the state.                                                  Photo by Eric Younghans | USF Health 



Continuing her advocacy on behalf of graduate medical students, Billington traveled to Washington, D.C., in 2013 to speak to Congress, requesting that the number of student residency positions reflects the number of physicians needed in an impending doctor shortage nationally, especially in the state of Florida.


In August, Billington will receive her doctorate in engineering, completing both of her degree tracks. As she begins the next chapter of her career as a resident in plastic surgery, Billington has no plans to slow down.


“The research started as an interesting question I wanted to answer,” Billington says. “Since then, a family member and close friend have been diagnosed with neurological disorders. Now I see my work as a lifelong passion.”


Billington intends to continue her research in pressure sore mapping, collaborating with medical students at USF to build on the algorithm and previous studies, as well as her efforts to help future medical students to secure a residency position.


“The community of USF and Tampa Bay really supported my research efforts and are a large contributor to why I ranked USF number one on my residency match list,” says Billington. “Wherever life takes me, I’ll always be a USF Bull.”


Katy Hennig is a multimedia journalist for USF News.