Posts Tagged ‘healthcare’
While the word “revolution” is used often during a period of rapid, intense innovation such as the one we are currently experiencing in healthcare, it can be helpful to step back to see what’s sparking the revolution. The answer may lie in the word, “frame.”
From a medical or scientific student’s traditional lessons in genetics (specifically, frame shift mutations), to changes in our perspective on a problem, frames make very significant impacts. Defined as a conceptual structure used in thinking, a frame helps us give an issue or problem borders, shape and structure.
This cognitive tool, while useful for our brains, also creates limitations. The linguist George Lakoff points out that every word in our language evokes a certain frame. And once evoked, other words reinforce that frame in our minds, until the image or concept is so strong that we can’t see through or around it.
Shifting Cognitive Frames to Foster Innovation
In her new book, InGenius, Dr. Tina Seelig, Executive Director for the Stanford Technology Ventures Program (STVP) at Stanford University’s School of Engineering, points to several ways to shift our cognitive frames to foster innovation. Frame shifting can come from trying to see an issue from several points of view. For healthcare, one could ask how a scientist looks at a new drug, versus how that drug may look to a family physician, surgeon, patient, family member, or child. Still another source of shifting frames (and revealing innovation) is the question, “why?” Seelig points to a continuous series of questions that start digging under our assumptions about an issue. In healthcare, for example, this can come into play in certain surgical procedures, where asking “why insert clamps manually?”, then, “why have clamps at all?” can start to lead to innovative treatments.
Getting back to the work of Lakoff, while his examples focus on politics, the pluses and minuses of frames and ways to use them are quite relevant to healthcare innovation. In digital health, some of these shifts are already happening; the smart phone can now be a diagnostic device, as well as a sharer of data. And many, if not most other areas of healthcare are seeing the benefits of taking tools from somebody else’s toolbox. For example:
- In the 1960’s, surgeon Lazar Greenfield worked with a petroleum engineer to design two new devices, intended for heart surgery. The first, the Greenfield Surfactometer was used to measure lung surface tension (which measured pulmonary surfactant, thought to contribute to pulmonary embolisms). This invention wasn’t used in the operating room for long, but it turned out to be a very good way to monitor water supplies for detergents.
- Greenfield’s second invention, the Greenfield Filter, trapped blood clots in a way that reduced problems arising from damage to the inferior vena cava. Again, Greenfield worked with an engineer, who saw parallels between blood clots and sludge in a buried pipeline. The filter has since been used in more than 600,000 patients.
- Today, the annual “Pumps and Pipes” meeting in Houston brings together cardiologists, cardiac surgeons, and petroleum engineers to address challenges in heart disease as well as the oil and gas industry (in both cases, we are talking about plumbing and drilling through cylinders, after all).
All three of these examples underscore the importance of frame shifting. Frames surround us, but so does innovation. In order for any healthcare revolution to flourish, we will need to make sure that our frames let us focus on new ideas and ways to solve health problems, rather than shutting down our vision.
At Popper and Company, the diversity of our team lets us shift frames to open innovation’s doors in ways that can even surprise us! We can help you create new strategies to help get your healthcare solution—and company—shifting in the right directions. To learn more, please subscribe to our newsletter, follow us on Twitter, or send me an email.
Tags: cognitive frames, cognitive tools, healthcare, healthcare innovation
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Scientists have puzzled over cognitive differences between men and women for at least 100 years. And the results of their work support the reality that should be on the minds of everyone working in healthcare; one size doesn’t fit all.
Researchers in Madrid and at UCLA recently tested men and women on cognitive tasks, including spatial reasoning, inductive reasoning, keeping track of tasks, and attention to numbers. Women, although they have smaller brains – and most importantly because of its role in memory, emotion and reason – a smaller hippocampus than men, were nonetheless better able to handle most of these tasks (except spatial), while showing less brain activity on an MRI. Thus, women require less neural material (and energy) to perform cognitive tasks on an equal level with men.
If this study holds up (other studies also point to significant cognitive differences between the sexes), its results may and should have an impact on healthcare innovation and service delivery. For example:
- At our firm we are very aware of the increased importance of the consumer in healthcare decision making. The way health information is processed by that consumer is very important. This has implications for both the device and the service interface. A consumer-focused device may be intuitive to one person, but baffling to another.
- One particularly strong area for women was in ranking and numerical tasks. New diagnostic tests often produce information that isn’t binary, but probabilistic. In this case, women might have an easier time knowing how to evaluate this information and make choices.
- On the other hand, men appeared to be much better at processing spatial information. This could play into the design of three-dimensional imaging technology, or even smartphone apps and videos.
A big question remains from studies like these; are these traits genetically wired, or more consistent with the way men and women have been trained to think? Perhaps, as Shakespeare showed us 500 years ago, things are more complicated; when Cleopatra’s complexity contrasts to Mark Antony’s hard reason, was that genetic or just the English writer’s perception of life in ancient Rome and Egypt? If it’s nature, then innovation needs to address these differences. If it’s nurture, then a wide range of other cultural differences need to be recognized.
At Popper and Company, we know that incorporating the role of the consumer is critical to successful innovation and strategy in healthcare. We can help you create new strategies, ideas, and inventions to address true unmet needs (and gender differences), and give your company (and its products) a sustainable market advantage. To learn more, please subscribe to our newsletter, follow us on Twitter, or send me an email.
Tags: cognitive testing, genetic traits, healthcare, healthcare innovation, healthcare strategy
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As I watch the power in healthcare shift away from physicians/providers toward consumers/patients (enabled by the wide access to information and driven in part by higher co-pays), I can’t help but to observe the affects of the Affordable Care Act on both this new power and the bedrock concept of healthcare delivery—“standards of care”.
Rob Lamberts, a physician who switched his practice from fee-for-service to “direct care” (in which patients buy in as a member instead of paying for each procedure and visit, and receive a basic set of services), has compared the changes in healthcare delivery to the upheaval caused by digital cameras. Just as the move from film to digital imagery brought photography closer to the consumer, mobile apps and web-accessible information will move healthcare delivery closer to customers (a.k.a., patients). Film companies like Kodak failed to recognize the disruptive innovations wrought by digital photography; could consumer power provide the same disruptive innovation to healthcare? As healthcare industry expenses approach 18% of GDP, the unsustainable weight of healthcare costs practically beg for such a disruption.
The Affordable Care Act (ACA), as well as other regulations and pending legislation, is addressing healthcare delivery standards and relating those standards to costs. The ACA will require health plans to be delivered at four levels of coverage: bronze, silver, gold and platinum. Bronze plans will require the highest copayments, and platinum the lowest. All, however, will have to cover basic benefits such as ambulatory services, emergency care, hospitalization, maternity/newborn care, mental health, prescription drugs, rehabilitation, laboratory services, prevention and wellness, and chronic disease management. At the same time, high-end concierge services—the so called “Cadillac health insurance”—will be subject to a 40% tax.
The sheer size of the plans under the ACA will require more standardization of insurance coverage, and new and potentially different concepts of “standards of care.” I believe we will see the basic package become the core “standard” with more costly but more generous premium services layered on top. And we will see a rapid shift from fee-for-service to global payments for various levels of service intensity.
But can you also have too much health care? Standards of care, developed by professional organizations, have traditionally answered this question. With these new levels of care, standards are no longer decided exclusively by physicians and specialists’ organizations; they’re increasingly influenced by patient choices. So the concept of guideline-driven medicine may no longer be in the eye of the physician but in the eye of the policy-holder.
Is the U.S. consumer ready for so much service choice? Where does the responsibility for consumer education fall? What mechanisms should we put in place to measure quality and reward efficient providers? Let us know what you think.
Tags: ACA, Affordable Care Act, guideline-driven medicine, healthcare, healthcare delivery, standard of care
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The concept of the citizen scientist is new to healthcare, since medicine has historically been physician-driven. But the citizen scientist has long been an important part of many other areas of science. With access to the Internet and social networking, the contributions of citizen scientists (and the body of knowledge they both access and create) are more profound than ever. In healthcare, the capability for genome testing takes this citizenship to a new level, opening the gates to truly personal medicine.
At the same time, as medicine moves away from reaction to prevention, we are seeing more attention paid to mitigating disease, improving quality of care, and reducing costs. Genetic testing can provide an early indication of disease that, in turn, provides an opportunity for early intervention or prevention, and helps target the right treatment.
Thus armed with information and the power of the genome, “citizen patients” can then turn healthcare into a less passive and more participatory enterprise, says Jill Hagenkord, Chief Medical Officer of Complete Genomics. These citizens may also usher in new philanthropic avenues, she suggests. Following is a recent post by Dr. Hagenkord, reprinted with permission of Complete Genomics.*
“Dr. Leroy Hood, president of the Institute for Systems Biology, captured the essence of genomic medicine by calling it P4 Medicine – predictive, preventative, personalized, and participatory. Genomic medicine represents a shift in the way we practice medicine. To understand this change, it is helpful to compare today’s patients and doctors to those of, say, 1993. Back when Nirvana was ruling the airwaves, medicine was still mostly reactive. A patient became sick—sick enough to see a doctor—then the doctor opaquely ordered tests, made a diagnosis, and prescribed therapy while the patient passively received care. That was the old paradigm. Today, the Web has helped to demystify and democratize medicine. Many patients are now well-informed before they seek medical care and they want to actively participate in their diagnosis and therapy choices.
Genomic medicine is not passive, it is participatory. And, in many ways, it is patient-driven rather than doctor-driven. Some people are proactively using genetic services like 23andMe to determine whether they have a genetic predisposition to certain diseases, or the genetic service Counsyl to make more informed reproductive choices. People are bringing these results to their doctors, not the other way around. These peeks into the genome provide individuals with the option to take preventative measures to reduce the likelihood of getting sick in the first place and to ensure they are getting “the right drug, for the right person, at the right time,” if they do get sick. Thus, genomic medicine is also predictive, preventative, and personalized.
Is there a 5th “P” in genomic medicine? I propose that genomic medicine is also philanthropic. In the Age of Genomic Medicine, patients are driven not only by the desire to understand and best treat their own disease, but also to prevent others from suffering from that disease in the future. Just as they want to participate in their own healthcare, they want to participate in their own research. The ability to sequence a genome has outpaced the understanding of what the sequence means, and unraveling the clinical meaning of the genome will take a village.
Citizen science represents public participation in scientific research. One example of citizen science is the social networking health site, PatientsLikeMe. PatientsLikeMe allows members to input real-world data on their conditions, treatment history, side effects, hospitalizations, symptoms, disease-specific functional scores, weight, mood, quality of life, and more, on an ongoing basis. The result is a detailed longitudinal record – organized into charts and graphs – that allows patients to gain insight and to identify patterns and communicate them to their physicians. The company transparently partners with academia and pharmaceutical companies, so they not only empower those suffering from a disease but also accelerate our understanding of diseases through research and clinical trials.
Citizen scientists will likely catalyze and accelerate our understanding of the genome beyond the pace that traditional research could accomplish. Motivated, empowered patients provide a positive feedback loop for genomic research. The more genotypes and phenotypes that can be generated and correlated, the better and faster we will understand genetic contributions to a particular disease.
This is an exciting time in the history of medicine. But healthcare and sequencing providers need to set appropriate expectations about what whole genome sequencing (WGS) can and cannot do today, as well as what it may be able to tell patients and their families tomorrow. WGS is not a panacea for all that ails humankind, but a powerful new tool that can catalyze our understanding of the genome and thereby empower patients and facilitate research that may lead to improved healthcare. As individuals and a society, we can then reap the benefits of medical care that is predictive, preventative, personalized, participatory…and philanthropic.”
Is a new era of the citizen scientist/citizen patient upon us in healthcare? Have innovations like social media, the internet and genomic screening made healthcare more discriminatory? How do they impact your life science company and its product development efforts? Are healthcare practitioners helped or hindered by this apparent growth in patient power? Share your thoughts with us.
* The original post appeared May 17, 2012 on the Complete Genomics blog. Read more at http://www.completegenomics.com/blog/.
Tags: citizen patient, citizen scientist, empowering patients, genetic testing, genomic medicine, genomic screening, healthcare
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While securing financing is an important milestone for developing new healthcare technologies, developers need to look beyond this first step and find ways to determine and demonstrate the value of their innovations. And there’s no better place to discuss this crucial issue than in Australia.
Home to 600 medical device companies, Australia ranks as the fourth-largest market in the Asia-Pacific region. I wrote this post last week from the 2012 AusMedTech (Australia Medical Technology) national conference in Sydney after sharing some strategic insights with device executives.
As the device industry continues to grow rapidly, it will be important for technology developers to demonstrate how their products add value to healthcare. No matter where they are located in the world, developers need to:
- Put their product in context right from the beginning:
- Think more about what real problem the invention is trying to solve. This means understanding the state of the industry, standards of care in health provider settings, and how and why the invention should change the status quo.
- Determine how resources would be affected by a new invention. This includes comparing the device’s cost against how much value it provides to the physician and/or to the patient.
- Consider the provider status quo, payor and consumer conditions, and the competitive landscape as they begin development of the product and not just prior to commercialization.
- Align development with current trends:
- Assess how the product meshes with the rise of the power of the consumer in healthcare, and determine how cost constraints at the consumer level as well could threaten the success of the product.
- Recognize that in every market cost constraints prevail. The new product needs to drive operation efficiency in service delivery and shift the value: cost equation firmly in the direction of value.
I look forward to continuing this conversation and plan to share in a future post my particular view around aligning with current trends. In the meantime, please feel free to share your thoughts here about the Australian medical device industry or about the points I’ve raised in this post.
Tags: 2012 ausmedtech, ausmedtech, australia medical technology conference, device industry, healthcare, medical devices, technology developers
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In my previous post, I discussed the need for healthcare companies to take a more market-focused approach to the healthcare consumer, including a more concentrated effort to segment the market and tailor strategies to different consumer groups.
Today, I’d like to explore the growing power of the healthcare consumer.
Overall, healthcare costs – both on the societal and the individual level – are increasing. Consumers are required, one way or another, to pay a greater share. So they are starting, albeit slowly, to ask questions about value. And they are interested in the value to themselves, individually, not to the population as a whole. How the consumer perceives healthcare value is an area that needs a lot of further exploration.
At Popper and Company, we have observed that an empowered consumer, armed with more information than ever before, is using this information to demand more tailored, customer-centric treatment from practitioners and institutions and from the tools and technology used. This customer demand is starting to move information from large centers accessible only to physicians, researchers or engineers to mobile devices, web sites and social media platforms accessible to nearly everyone.
How might healthcare innovators respond to such changes in customer demand?
- Create new metrics, like the popular Consumers Union of the U.S. rankings, that measure how customers rate a product (high/low acquisition costs, maintenance costs, product lifespan) according to their preferences. This would require healthcare providers and technology developers to consider customer input in their products and services. More significantly, it would require them to be able to describe their products and services in a way that’s comparable to a competitor’s (and in ways that consumers will understand).
- This new “report to consumers” would require the development of information systems that can read customer behavior, wants, and needs. Seeing patients as customers means considering how these customers will react to products or services, and taking those reactions into account when designing a product or service, or when developing a new treatment strategy.
Certainly, this would require quite a paradigm shift in the life sciences industry, but it’s the way our colleagues in the automobile, electronics, and durable goods industries work every day. Now, as in these other industries, consumers can educate themselves and retrieve information easily. Therefore, it’s probably time that our industry joined those other industries in putting consumer perceived needs first or a the very least on a par with what the health care providers think is “good for them.”
Do you think a consumer ranking system is possible broadly in healthcare? How readily are you now able to capture your customer’s ratings and opinions of your company or its products? Are there any other ways those developing healthcare solutions can integrate and embrace the changing role of the customer? Please share your thoughts with us.
Tags: consumer report, empowered consumer, healthcare, healthcare consumers, healthcare marketing, healthcare providers, healthcare solutions
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I had the very fortunate opportunity to meet with Dale Alverson, M.D., Medical Director of the Center for Telehealth and Cybermedicine Research at the University of New Mexico and current President of the American Telemedicine Association (ATA). Dr. Alverson has been instrumental in bringing telemedicine to New Mexico for the last several years, and is now actively engaged in bringing telemedicine to the rest of the world.
Telemedicine, defined by the ATA, is the use of medical information exchanged from one site to another via electronic communications to improve patients’ health status. Closely associated with telemedicine is the term “telehealth,” which is often used to encompass a broader definition of remote healthcare that does not always involve clinical services. Videoconferencing, transmission of still images, e-health (including patient portals), remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telemedicine and telehealth.
Dr. Alverson presented at the ATA’s Fourth Annual (2010) Mid-Year Meeting in Baltimore this past September. His presentation was entitled “The Perfect Storm.” He described significant changes occurring – and which will continue to occur – given the current conditions in the U.S. healthcare system and the convergence of some key elements within, including:
- Need for effective and affordable health care
- Need for access to care
- Integration of new and emerging technologies
Following are excerpts from my interview with Dr. Alverson:
Q: What is the significance of telemedicine?
A: Telemedicine is becoming a standard of care and is utilized in many healthcare programs including early detection and early intervention programs.
There is evidence that telemedicine/telehealth programs have favorable outcomes. One example is the success of a program in New Mexico called the ECHO (Extension for Community Healthcare Outcomes), which is led by Sanjeev Arora, M.D. This program has shown improved outcomes for patients with hepatitis C infection who may not otherwise be able to receive the care and treatment needed for their condition. Through the ECHO program specialists collaborate with healthcare providers in rural areas of New Mexico and provide quality healthcare to patients living in areas where access to care may otherwise be limited or nonexistent.
The ECHO telemedicine model has reached beyond the treatment of hepatitis C to address several other chronic illnesses. Additionally, the program provides rural practitioners access via videoconferencing to a much larger professional community enabling the rural practitioners to enhance and expand their skills.
One of the major funding sources for the ECHO was from AHRQ (Agency for Healthcare Research and Quality, Dept of Health and Human Services) under THQIT (Transforming Healthcare Quality through Information Technology).
There are many other projects developing across the U.S. and many new and innovative technologies in the market. During this time of urgency to create change in healthcare, there are also many unsolved issues that need to be addressed as telemedicine becomes a standard of care.
Q: What role does the ATA play?
A: The ATA is the leader in telemedicine. The organization began in 1993 with the purpose to create standards, guidelines, and policies and to serve as a resource to distill information to its members. The ATA works in collaboration with several federal agencies, such as the FDA, FCC, CMS, VA, DOD, as well as with international stakeholders, industry, and others involved in healthcare.
Q: What questions still need answers before the full potential of telemedicine can be achieved?
A: We need answers to questions such as:
- What are the best devices to use given there are so many and that the technology is changing and improving everyday?
- Who is reviewing the data coming through the device?
- How is the data acted upon?
- What will be done with the data?
I was fortunate to talk to Dr. Alverson, a thought leader in telemedicine, and I look forward to sharing additional insights from this rapidly evolving and important segment of the health care sector.
Do you feel there are other related questions that should be addressed? If so feel free to make suggestions here, and stay tuned for more information on this critical topic.
Tags: ATA, Dale Alverson, health innovation, healthcare, mHealth, patti doherty, public health, telemedicine
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