As life-changing and life-saving as medical devices and technology can prove to be, they are sometimes wasted effort. The difference between a blessing and a bust can often be traced to initial planning. For ultimate value, the need and the proposed solution must be vetted — and perhaps suggested — by the users. To be problem solvers and not just manufacturers and developers, life sciences companies turn to health care providers for inspiration. The best guidance comes from providers who are attuned to innovation.
Creative thinking about health care benefits might involve life sciences at any point. A provider focused on making improvements can renew anything from daily routine to procedures in the hospital or system, or multiple unrelated systems. A provider can prompt revisions in medical training. He or she can share concerns with others who then connect with life sciences professionals. The collaboration could start with an inventive idea and produce a practical, original product.
A believer in the imperative for health care and life sciences professionals to work together, Dr. Rajesh Aggarwal, a bariatric surgeon and leader of pioneering initiatives at Thomas Jefferson University Hospitals in Philadelphia, collaborates and co-creates with engineers, designers, artists and computer scientists to bring health care innovation to his patients. He offers actionable advice for providers to transform patient care and the industry itself.
I see myself as a health innovator, change-maker and disruptor of the status quo — for that is the only way that our monolithic health care systems can be transformed.
Rajesh Aggarwal, MD, PhD, FRCS, FACS
Senior Vice President
Jefferson Strategic Ventures
Professor of Surgery
Thomas Jefferson University and Jefferson Health
- Create new team habits
Nurturing teamwork — with other providers, the wider health care community and life sciences companies — can start immediately. Being inclusive of all colleagues grows opportunities for valuable input. An example was given by Aggarwal: “I was operating today; at the beginning of every case we have a timeout. I had two medical students in the room with me. I made it a point to say safety is a team effort. If you have any concerns, please speak up.” A gesture as simple as this can be an opening to productive collaboration.
- Rethink hospitals and systems
At the mention of “hospital” or “health system,” “brick and mortar” springs to mind. Patients arrive at the door with a problem, having made an appointment according to the schedule. But as the current state of shopping centers shows, this isn’t what works for many people today. We want experiences to be simple and fast. Devices make that possible. As Aggarwal pointed out, just as the term “telebanking” has faded to become just “banking,” “telehealth” will morph to just “health care.” It will continue to advance to a presence on phones and computers, wherever the patient is. Integration, desirable now, will be essential in the future. The transformation will require proactive collaboration on numerous fronts.
But transformative change can begin with one determined individual. The fragmentation of stroke care was a worry for Dr. Robert Rosenwasser, the chair of the Department of Neurological Surgery at Jefferson University Hospitals. He set about to fix it. He created a program that supplied telerobots to emergency rooms in 35 Philadelphia-area hospitals, the majority of which have no affiliation with his own. A patient coming to an ER with symptoms of a stroke receives a CT scan. Within 12 minutes, at no cost, a connection is made and Rosenwasser, or one of the other experts on his team, advises the ER physician about diagnosis and treatment. “That’s not telestroke, that’s stroke,” said Aggarwal. “That’s how to deal with stroke. This is mission based, and the quality of stroke care in Philadelphia has improved 400%.”
The quality of stroke care in Philadelphia has improved 400% because of one person’s innovative idea about collaboration. The “Jefferson Neuroscience Network” model, posited Aggarwal, could be applied to other concerns, such as sepsis. Countrywide, he said, experts could “beam in” responses to this top cause of hospital readmission. This kind of innovation establishes “a real-time, responsive and effective health system as opposed to bricks and mortar.”
- Reimagine medical training
Aggarwal advocates for revolutionizing the education of providers. “When you look at the way we train doctors,” he explained, “we still have hierarchies. We have a culture where medical students aren’t allowed to speak up. And when you have that kind of culture, how do you innovate? ‘If you learn all this by rote and you pass all this, then you will pass the exams, you’ll be able to be a doctor.’ That’s completely foreign to folks trying to do innovation, whether they’re in Silicon Valley, Boston, Philadelphia — wherever they are. They’re like, ‘We’re here to break the rules. We don’t even know what rules are.’
“So imagine a medical school that says, ‘We’re not actually going to teach you to follow the rules. We’re not going to even stand in a lecture hall. We’re going to ask you what you think is important for you to be a health care practitioner, for you to be able to transform health care.’”
- Align on medtech-health care innovation
With value-based care and greater emphasis on patient engagement becoming the standard, life sciences and health care efforts must align on “high touch,” Aggarwal’s term. “The high-tech part has got to improve the high-touch part,” he said. Products have to serve the patient, but also the provider. Much like Uber, Aggarwal explained, which realized its customers are actually the drivers, medtech companies must engage providers in developments that will improve their experience of caring for patients as well as patient care itself. Doing so requires a business model that seeks input from all stakeholders.
- Ensure match-up of need and solution
Meaningful change requires discipline. A social scientist Aggarwal knows refers to “the ugly baby syndrome.” A newborn is the most beautiful baby in the world to a parent, but that can’t be true. An innovation without a value-based proposition is a wonderful thing only in the eyes of its medtech creator.
The goal is to understand the value of an innovation — whether it’s worth the money and actually improves patient care.
National Managing Principal
Health Care and Life Sciences
The da Vinci robot, Aggarwal said, is case in point. “To my knowledge,” he said, “we are lacking clinical evidence that the technology has improved outcomes, yet there are 5,000 da Vinci robots around the world. The technology is expensive, and we lack evidence that it benefits the patient.”
Appropriateness and efficacy are the focus of product research by the Medical Device Innovation Consortium. Grant Thornton National Managing Principal of Health Care and Life Sciences George Serafin explained: “One of the workstreams is around analytics and the idea of consumer reports for devices. The challenge is, of course, getting reliable data to look at outcomes, costs and benefit. There are initiatives underway to meet the challenge. The goal is to understand the value of an innovation — whether it’s worth the money and actually improves patient care.”
- Think like a start-up
No matter its age and maturity, a medtech company that takes the position of a start-up sees each health system as a “lighthouse account,” said Aggarwal. Though it might be a vendor of numerous health systems, the company will use its experience not to duplicate but to inform. It will take a humble approach to solicit input from providers and shape a solution accordingly.
As health care providers and medtech professionals act as collaborators (to solve problems) rather than as client and vendor (to supply tools), their pursuit of life sciences innovation will improve outcomes for patients in hospitals, health systems and the wider community.
National Managing Principal, Health Care and Life Sciences
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