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Iadh innovation in healthcare r4
1. Health Improvement through Innovation Session 4: Research-based Design: An Evaluation Tool for Improving Healthcare 7th World Congress
2. A The Promise of Innovation How Facilities Impact Innovation Lessons from HDR’s Translational Health Science Initiative
3. Introduction: in·no·vate [in-uh-veyt] verb to introduce something new; make changes in anything established. generally refers to the creation or improvement of products, technologies, or ideas “Appreciative Inquiry (AI) as a systematic discovery of what gives life to a living system (ie. in our case an organisation) when it is most alive, effective and constructively capable.” D. Cooperrider “We can’t solve problems by using the same kind of thinking we used to create them” -A. Einstein “medicine is not a science: it is the clinical practice of healing the given individual” -Wikipedia
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5. HIM pervasive use in development of Best Practice - EBM - Comparative Effectiveness
6. Transition from the primacy of the Patient - Physician relationship via Care Extenders
7. “Reorganization of Primary Care as Disruptive Innovation: From Molecules to Practice - HIT and the Medical Home” CIMIT4
8. The Threat of Innovation – Dr Tim Johnson The Theory of Translation The View Friday Nov. 5th 2010 “The biggest threat to our Healthcare industry is the blatant introduction of expensive unproven technologies” “If we don’t bend the cost curve we’ll be bankrupt in 8 years”
9. 100% I H E A L T H S T ATUS I 0% Birth Projected human life span 120 Years
10. The Square Wave Life Curve 100% I H E A L T H S T ATUS Jeanne Louise Calment Photo by N'geenTien-Gamma Liasion I 0% Birth Projected human life span 120 Years
11. TGP’s Value Proposition: The Patient Personalized Medicine Partners Patients Researchers Predisposition analysis with behavior modification and exposure avoidance Achieve a molecular diagnosis 4 1 Parental carrier screening and reproductive decisions for monogenic disease 2 Ongoing research results returned to clinical practice to improve patient care 5 Ongoing relationship that will improve decision heuristics and improve care 6 Earlier and more appropriate interventions 3 CHB Catchment Age Impact (Ages 0 – 21) DNA Sequencing, Initial Results Return, Conduct Research, Ongoing Results and Patient Re-engagement, Impact Practice of Clinical Care CHB Ongoing Care Impact (Ages 21 and over) Conduct Research, Ongoing Results Return, Family Re-engagement, Impact Practice of Clinical Care Diagnosis and Familial Carrier Status Post-Disease Management Predisposition, Environment, and Pediatric Care Management Interaction with Primary Care Provider Interventions and Adult Care Management
12. Patient Care Paradigm Whole Body Organs and Systems Cells and Tissue Genes and Molecules
13. b How Facilities Impact Innovation Medical Arts Intuitive Medicine Multidisciplinary Specialists Experience Evidence - Based Medicine Knowledge Technologists Precision Medicine Medical Science
14. Disruptive Technologies to Meaningful Use The Theory of Translation Device Data Transmission Steam Engine Medical Records Wireless Core Enabler Wired Communication Virtual Grid Rails TCP-IP Innovation Health Information Exchange Social Networking High Speed Train Video Conferencing
17. “Strange Attractors…deal with the rich and diverse types and sources of information which could potentially inform decisions” G.R. Gates MRI Optical probes Gamma probe Beta probe In vivo imaging In vivo spectroscopy PET Histology MRI PET Navigation Pathology Ex vivo spectroscopy Validation of Multimodality Imaging Disruptive Technology
18. c Lessons Learned from HDR’s Translational Health Science Initiative
19. Translational Health Science Center Design Kit of Parts Clinical Trial Intervention Patient Care Hospital | Out-Patient Care Lab Translational Zone Bioinformatics Research & Development Faculty | Classrooms Medical Education Simulation Vivarium
20. Translational Facility Typology The Evidence of Translation Single Organ / Disease Specialty Transdisciplinary Integration Multiple “Centers of Excellence” KnowledgeTransfer KnowledgeTransfer Mechanical Mechanical Mechanical Laboratory Clinic Hospital Office Clinic Laboratory Office Hospital Clinic Office Office Laboratory Hospital Support / Technology Support / Technology Support / Technology Laboratory Clinic Hospital Med Ed / Outreach Amenity / Interaction Clinic Hospital Laboratory Vivarium Core Tech Core Tech
21. Vertical Integration to Horizontal Integration The Evidence of Translation Inpatient Research & Admin Diagnostic & Treatment Research Ambulatory
24. VISION | MID-CAMPUS EXPANSION Brigham and Women’s Hospital Future Site of Patient Tower AMIGO Suite BWH Cardiovascular Center New 350,000 sf Translational Research Building
25. Delivering on a Concept iPad? iPhone? What device made by Apple has had the most disruptive impact on the handheld industry? Newton! The Newton, which failed because it was technology without application
Notes de l'éditeur
Innovate vs invent problem solving or appreciative inquiry developed @ Cleveland Clinic practiced at Harvard Business SchoolMedicine as science
G. Timothy Johnson (born 1936) is an Americanacademic, pastor, physician, television journalist and writer who, as "Dr. Tim Johnson", is best known to television viewers as the longtime chief medical correspondent for ABC News on the ABCtelevision network.For many years he has been a member of the faculty of the Harvard Medical School at Harvard University and on the staff of Massachusetts General Hospital, a teaching hospital of the Harvard Medical School and a biomedical research facility in Boston, Massachusetts.
The gene partnership Dietrich Stephan
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Richard Gilfillian of Geisinger to lead CMI Center for medicare and Medicaid Innovation
Six months after centralised stroke services were opened in the capital, figures show that more Londoners are being given life-saving drugs to quickly restore blood-flow to the brain after a stroke. This treatment is proven to reduce lasting disabilities and could save hundreds of lives every year. Since centralising stroke care in eight Hyper Acute Stroke Units (HASU) rather than in most hospitals, London has seen: More patients being given clot-busting thrombolytic drugs than anywhere else in the UK or other large cities around the world; Patients taken from home to HASU by London Ambulance in under 15 minutes on average; Patients recovering quicker from a stroke, spending on average four days less in hospital.
An operating room that is also a laboratoryA laboratory that is also an operating roomPopulated with state of the art equipmentNIH funded.Not under pressure to be profitable“The principle is one of disruption. Agents are forced out of their habitual patterns and, individually or in small groups, build new relationships and behaviors that are more productive or adaptive” G. Eoyang
Proving ground Risk is focused tool up for innovation
Academic Medical Centers are comprised of three major areas: Patient Care, Medical Education and Research & Development. Within these areas, are a variety of critical components, a “kit of parts.” These parts can be physically independent of one another, and function independently, too. This has been the standard approach for years.
Vertical organization can work very well, because the proximities are there. This is where the actual design is so important. It’s a matter of designing support, circulation and amenity spaces to foster interaction among patients, clinicians and researchers and enhance knowledge transferFirst Generation “Bench to Bedside”Center of Excellence “Silos”Focus on Single Disease / OrganIntradisciplinary Integration Second Generation Multiple “Silos”Multiple SpecialtiesInterdisciplinary IntegrationShared Core ResourcesThird Generation “Translational”Transdisciplinary IntegrationCo-located Core ResourcesOther challenges inherent in a vertical building, are maintaining correct flows with vertical circulation and aligning the structural grid and infrastructure for clinic, office and labs.
As much as we need to invent tomorrow’s technology, we need to take the technology that exists today and as Apple has done so well, create a coreplatform for innovation leading to “meaningful use”
