Transcript Slide 1

Innovation
Its role in Delivering Better
Health Outcomes
Professor Orla Hardiman
HRB Clinician Scientist
THE PROBLEM
Health Expenditure is
Escalating
Anderson G F , Frogner B K Health Aff 2008;27:1718-1727
Use of hospitals
Population health triangle
5%
15%
Disease Severity
80%
Undiagnosed
disease
Healthy population with
risk factors
We all the usual methods
but it still wont work!
We tried everything,
but it still wont work!
INNOVATE!
Latin: Innovare
To renew or change
INNOVATION:
Individual Barriers
INNOVATION:
Institutional Barriers
INNOVATION IN THE
HEALTHCARE WORLD
RATIONING HEALTHCARE
BUDGET
HOW?
WHO?
WHO?
WHAT?
STAKEHOLDERS
• Society at large
• Healthcare professionals
• Industry
• Users (citizen/ patients)
SOCIETY
SOCIETAL INNOVATIONS
• IMPROVE KNOWLEDGE BASE
• Eliminate ineffective / inappropriate services
– (How to define these?)
• Cut the volume of least cost-effective services
– (How to define?)
Rationalize Services
Societal Innovations
• Strengthen Governance
& Accountability
SOCIETAL INNOVATION
(NEW TREATMENTS)
• Strengthened HTA but limited use in cuts
– Evaluate the metric
– Act on HTA recommendations
• European Network for HTA
INDUSTRY
INDUSTRY INNOVATION
• Drug Development
– Reassess models
• Partnerships & Collective innovations
TARGETTED DRUG DEVELOPMENT
Disease State
Gene locus / Environmental
Medicinal
Chemistry
Human
trials
In vivo
therapeutic
Cell
Biology
Animal
Model
In vitro
therapeutic
Failures in Translation
“ Valley of Death”
PARTNERSHIPS
• Clinical Databases & “Deep phenotyping”
• Academic collaborations
INDUSTRY INNOVATION
• Personalized Medicine
Industry Innovation has Societal
Implications
Challenges for Industry
• Pharma’s contract with
society is a mainstream
issue
• Industry survives
because it is seen as
socially useful.
• If that perception falters,
so does the business
model
MEDICAL PROFESSION
Innovation:
Medical Profession
• Value of Preventative Medicine
• Power sharing
• Teamwork
Clinical Governance
• Recognise link between diagnostics,
care and cost
• Clinical autonomy balanced with
accountability
• Continuous quality improvement
Deming
EXAMPLE: EPILEPSY PROGRAMME
Summary National Epilepsy Programme
THE PATIENT
The Citizen Patient
• Patient is an integral member of the team
• Patient as citizen has both rights &
responsibilities
• Societal implications for how to ration
Innovation:
The Patient as “Superconsumer”
• Autonomy
– Knowledge about individual health
status
– Informed choices
• Ability to question / adjust /accept
/reject treatments
IMPLEMENTATION
Challenges
Deming Cycle