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Tag: Innovation

New Johnson & Johnson CEO Discusses Medical Device Futures at Stanford Event

It will take more than a Band-aid to fix the medical device market. This was the message delivered by Alex Gorsky, future Johnson & Johnson CEO, to an auditorium full of students and entrepreneurs at the Stanford Biodesign From the Innovator’s Workbench event last week.

Gorsky, who in a few weeks will take the helm of the world’s largest health-care corporation, discussed challenges and opportunities in medical device market, as his company navigates through a turbulent world economy and a string of product recalls.

“It’s a difficult market,” he said. “The days of incremental innovation are over.”

And, while Gorsky thinks population growth will drive up worldwide demand for health care, it’s unclear who will pay for it.

Gorsky sees a fundamental shift in the way medical devices are purchased, which may change the innovator’s design approach. In the United States, buying decisions will shift from surgeons to cost-conscious hospital buyers. And that may create demand for keep-it-simple medical devices – designs that provide 50 percent of the bells-and-whistles of current devices for 15 percent of the cost. In addition, he cited the need for more clinical information on efficacy and safety, to help hospital administrators justify medical device purchases.

As the U.S. struggles to stem rising health care costs, his company will look to emerging markets – especially China – for growth. He predicts that these health care markets will grow at 4 to 5 times the rate of the domestic market.

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Healthy Competition

While there are important differences between the NHS and the US health system, both face similar challenges in improving productivity and disrupting the traditional model of healthcare that is no longer fit for purpose. Both are facing rising demands of an ageing population, increasing prevalence of chronic conditions and consumer expectations. Both systems have powerful incumbent providers such as general hospitals that are not always responsive to changing patient and system needs. As Elizbaeth Tesiberg and many others of both sides of the Atlantic have argued, “innovation is the only long-term solution to high-quality, affordable health care.”

Leading pioneers from around the world are already transforming healthcare. In its recent report, Healthy competition, the London based think tank Reform, highlighted a number of case studies of successful change. Reform explored four crucial areas that can improve productivity in healthcare: service reconfiguration, integrating care, standardisation of processes and procedures, and measuring and publishing outcomes.

Greater patient safety through service reconfiguration

Successful reconfiguration has achieved higher quality and greater value for money. In Finland, the Pirkanmaa region closed joint replacement departments in five hospitals and concentrated care at one specialist hospital.  The new hospital delivered complication rates below 1 per cent compared to an average of up to 12 per cent for general hospitals. The NHS in London moved emergency stroke care from 34 general hospitals to eight specialist units with dedicated staff. London now has the highest standards of stroke care of any major international city.

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Wrong Rx for the FDA

The congressional legislators who oversee the Food and Drug Administration and control the nation’s coffers have shown again that they neither understand drug development nor the regulatory problems that plague it.

In February, Sen. Barbara A. Mikulski(D-Md.) unveiled a bipartisan bill intended to spur innovation in research and drug development for chronic, costly health conditions such as Alzheimer’s disease, cancer, diabetes and heart disease.

According to the press release, the bill will invest “in public-private partnerships to ensure scientists and researchers are able to develop new safe and effective drugs,” shrink product development timelines, increase the number of drugs in the development pipeline and expedite the FDA review process.

However, there is currently plenty in the development pipeline. The federal government is boosting funding for research and development on Alzheimer’s disease; the Department of Health and Human Services alone will allot more than $500 million to it in fiscal year 2013. Moreover, drug companies spend more than $65 billion annually on R&D.

For example, there are now nearly 100 drugs in development for Alzheimer’s disease, dementias and other cognitive disorders, and almost 900 medicines being tested for cancer.

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Harvard Business School Future of Healthcare Conference

Personalized medicine, iPads, insurance exchanges, non-profit/private partnerships…what will healthcare look like in 2020? The healthcare industry today is under enormous stress. Big Pharma is struggling to fill its pipeline, and the biotech industry has failed to deliver sustainable profits for its investors. Health plans operate under enormous uncertainty as reform hits one political roadblock after another. Hospitals struggle to find profitable business models, while patients struggle to find safe, affordable and high-quality care.

But the future of healthcare remains incredibly promising. Scientific discoveries and business model innovations are shaping the healthcare of tomorrow, today. But what will that future look like? On February 4th, over 600 industry leaders, professionals, and students will gather at Harvard Business School for its 9th Annual Healthcare Conference to answer that very question.  Karen Ignagni, CEO of America’s Health Insurance Plans (AHIP) and one of Modern Healthcare’s “100 Most Influential People in Healthcare”, will discuss the future of the health insurance industry.  Other keynote speakers include Bill Crounse, Senior Director, Worldwide Health for Microsoft and contributor to Microsoft Healthblog, and Larry Culp, CEO of Danaher, who will discuss broader trends in healthcare IT and innovation.

A variety of topics will be debated during panel sessions where moderators are encouraged to challenge panelists to envision the healthcare business models of tomorrow. In the Biotech & Pharma panel, for example, panelists will discuss the rise of tailored therapeutics―Dr. Stephen Spielberg, Deputy Commissioner of the FDA, will provide his perspective on the regulation of personalized treatments. The Payor & Provider Panel will explore the shift to an outcomes-based future―Regina Herzlinger, author of “Who Killed Health Care?” and often dubbed the “Godmother” of consumer-driven Healthcare movement, will share her viewpoint.

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Why Getting to a Digital Health Care System Is Going to Be Harder Than We Thought Ten Years Ago

A leading scientist once claimed that, with the relevant data and a large enough computer, he could “compute the organism” – meaning completely describe its anatomy, physiology, and behavior. Another legendary researcher asserted that, following capture of the relevant data, “we will know what it is to be human.” The breathless excitement of Sydney Brenner and Walter Gilbert —voiced more than a decade ago and captured by the skeptical Harvard geneticist Richard Lewontin [1]– was sparked by the sequencing of the human genome. Its echoes can be heard in the bold promises made for digital health today.

The human genome project, while an extraordinary technological accomplishment, has not translated easily into improved medicine nor unleashed a torrent of new cures. Perhaps the most successful “genomics” company, Millennium Pharmaceuticals, achieved lasting success not by virtue of the molecular cures they organically discovered, but by the more traditional pipeline they shrewdly acquired (notably via the purchase of LeukoSite, which ultimately yielded Campath and Velcade).

The enduring lesson of the genomics frenzy was succinctly captured by Brown and Goldstein, when they observed, “a gene sequence is not a drug.”

Flash forward to today: technologists, investors, providers, and policy makers all exalt the potential of digital health [2]. Like genomics, the big idea – or leap of faith — is that through the more complete collection and analysis of data, we’ll be able to essentially “compute” healthcare – to the point, some envision, where computers will become the care providers, and doctors will at best be customer service personnel, like the attendants at PepBoys, interfacing with libraries of software driven algorithms.

A measure of humility is in order. Just as a gene sequence is not a drug, information is not a cure. Getting there will take patience, persistence, money and aligned interests. The most successful innovators in digital health will see the promise of the technology, but also accept, embrace, and ideally leverage the ambiguity of disease, the variability of patients, and the complexities of clinical care.
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E-mail from TEDMED

It’s the kind of event where you might find yourself (as I did) seated between the Surgeon General and a Nobel Prize winner in Chemistry, with a singer/actor/model type across the table. Yet somehow, everyone finds common ground.

Once again, a who’s who of people descended on San Diego for TEDMED – three days packed with smart, provocative folks discussing how Technology, Entertainment, and Design play out in the healthcare field.

We’ve been attending TEDMED for a few years now, and this one might just be the best we’ve seen yet. From my perspective – an engineer at heart who’s devoted the past twelve years to growing a healthcare technology and communications company – TEDMED boiled down to this: the challenge of managing a range of increasingly complex systems, the need for collaboration, and a clear call to action to effect change.

We’re not kidding when we talk about complexity. A few highlights:  Dean Kamen (one of my  former bosses and current mentors) of Deka Research &  Development and David Agus of the University of Southern  California made their respective calls for a more responsive  regulatory environment in the face of more complex and sophisticated medical breakthroughs, as well as an approach for documenting  the social cost of not approving them.  Eric Schadt of Mount Sinai School of Medicine described the dizzying complexity of genetics the way an engineer might model a network – think of a GPS for your DNA – helping even those (like  me) who can’t grasp the genetic system understand how it works and how personalized medicines interact with  it.

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Orphan Innovations

If someone has invented a successful, innovative, cost-effective social program, doesn’t it seem likely that it would spread quickly to other communities?  Susan Evans and Peter Clarke have written a fascinating article detailing why many programs become “orphan innovations” that no one else adopts.

The authors describe a program started by a retired produce wholesaler in Los Angeles, who convinced distributors to donate slightly spoiled produce to food banks.  Before long, poor families were receiving fresh fruits and vegetables that would have been dumped in landfills.  Evans and Clarke took it upon themselves to make sure that this program was adopted in other cities, but ran into many roadblocks, such as skepticism from overworked local officials that the program would work.  Eventually, through sheer determination, they succeeded: the program spread to dozens of communities.  But it took 20 years of hard work, creativity, cajoling, and financial support.

Their conclusion?  A social program cannot simply be transferred from one locale to another.  Instead, it has to be customized at each new location.  Unlike a fast food chain, that plops a carbon copy of a restaurant down in every community in American, social programs have to be adapted to the particular staff, clients, and ecology of each setting.

There are valuable lessons to be learned here for those of us interested in social psychological interventions that improve human welfare.  There is a growing movement to translate social psychological theory into interventions that help people in the real world, including ones that help people recover from traumatic events, prevent child abuse, reduce adolescent behavior problems, and close the achievement gap in education (as I chronicle in my book Redirect).  Critically, these interventions are being tested with well-controlled experiments, to see if they work. This is a huge advance over relying on common sense, which has led to the wide-spread adoption of programs that don’t work or do harm (see my earlier post, Testing, Testing).

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