What happens when dozens of doctors, company executives, patients (in the form of professional athletes like retired NBA star Zydrunas Ilgauskas and triathlete David Scott) gather to discuss the state of healthcare innovation?
At the 2012 Medical Innovation Summit, they occasionally disagreed but for the most part focused the conversation around a few key themes. Here’s a quick recap of some of the big ideas that kept being repeated.
Importance of data
The general outlook toward innovation in the orthopedics field was mixed, but one thing everyone agreed on was the increasing importance of data in several regards.
Orthopedic surgeons have been slow to adopt new technologies because of what I heard referred to as “embedded conservatism.” Many of the procedures they do are elective, low-risk and have been proven successful over time, so in order for them to adopt something new, they need to see that it can deliver outcomes that are truly better. Thus, they need a lot of evidence – not just clinical data, but long-term patient outcome data (hence the slow moving innovation cycle).
In the move toward more personalized care, they also need to be able to look at that data layered with other patient data. “I think a lot of the value is going to be able to juxtapose data that’s existed previously in different silos – by taking data from one venue and merging it with another,” said Mark Smith, director of the MedStar Institute for Innovation, on a panel about big data.
And, they need to be able to access patients’ data wherever they are. “Easy access to data is clearly a huge opportunity for innovation,” said Dr. Joseph Ionnatti, chairman of the Orthopaedic and Rheumatology Institute at the Cleveland Clinic. “The next generation is saying, I want my healthcare data available to the person taking care of me, no matter where it is.”
Moving beyond episodic care, with a focus on a continuum of care and doctor-patient relationship
Data could also help enable better predictive analysis, which would help orthopedic surgeons better match patients with the most appropriate course of treatment for them. David Dvorak, the President and CEO of Zimmer, noted during his one-on-one that as diagnostic capabilities become more sophisticated, patients’ expectations for care are becoming much higher. In a separate one-on-one, Biomet CEO Jeffrey Binder echoed that there are “tremendous opportunities for us to intervene earlier in the disease process.”
Intervening earlier and matching treatments fits into a larger scheme of moving beyond episodic care and toward a better doctor-patient relationship to both improve outcomes and reduce costs.
One of my favorite comments made during the conference came from David Cutler, an author and research associate at the National Bureau of Economic Research. “The interesting thing about healthcare is that the customers are more willing to help you out than they are in almost any industry,” he said. “They’ll come to you with ideas – some are right, some are not – but they want to be involved in their care, and so far we haven’t been able to do that. There’s a demand of people wanting to help out, and at the time we’re really just wasting their talents.”
Building on existing technologies
Innovation needs to extend beyond metals and plastics and into the delivery system. That includes making the time surgeons spend before, during and after surgery more efficient.
Technology-wise, there is potential for game-changing new treatments in this field, like the use of biologic drugs that are being studied with great interest, but incremental innovations in orthopedics are more likely, and that’s OK. Unlike other industries, this one has in general tended to be averse to major paradigm shifts.
Some of the opportunities I heard mentioned were technologies to improve the longevity of implant components, intra-operative imaging or sensor technology that would improve surgical techniques, tools that would reduce the risk of infection and interval procedures to cut down on total joint replacements.
“The innovation that has to occur is in changing relationships,” said Dr. Mark Froimson, president of Euclid Hospital (Cleveland). “It’s not about selling a product to a surgeon anymore, it’s about making yours the preferred product in a healthcare system because it’s a good product and it has good patient outcomes.”