Globalization of Innovation a ‘Must Have’ to Improve Health Care Delivery

MIAMI BEACH, FLA.—A global approach to innovation coupled with rapidly improving technology will help streamline the delivery of care and improve patient outcomes.

“This is a world that is implicitly inhibited by redundancy, by added costs, by time delays and, ultimately, by limited knowledge rather than aggregated knowledge, particularly where rare but catastrophic safety concerns may lie,” said Mitchell W. Krucoff, MD, of Duke University Medical Center, at TCT 2012. “This is the world we need to change, and … it is very actively changing.”

From concept to reality

The concept of global innovation is far more complex than the barriers posed by geographic boundaries, Krucoff said. Stakeholder boundaries — including regulatory approvals and post-market surveillance, reimbursement decisions, best practice guidelines, and competitive marketing and research and development practices — create silos that contribute to inefficiency and undermine efforts to aggregate safety information worldwide, Krucoff said.

“Innovation is an ecosystem, and the more we can align the processes and objectives that we all share in that ecosystem, the more each can then participate in their individual stakeholder objectives,” Krucoff said.

Strategies that can help ensure success include precompetitive collaboration through public-private partnerships, as well as the use of consensus definitions — particularly with regard to safety events —that help create a larger pool of knowledge and information. Global infrastructure for research and surveillance must be addressed, and regulatory convergence is also essential, Krucoff said.

“We have to recognize globalization of innovation as a ‘must have.’ This is not a ‘nice to have,’” Krucoff said. “This is critical to the global economy. This kind of thinking will help us eliminate redundancy, improve safety information quality, lower costs, accelerate innovation time to the bedside and change the world we live in.”

Incorporating new technologies

The digital revolution also will help make care more efficient, said Peter J. Fitzgerald, MD, of Stanford University.

The variation between how procedures and diagnostics are performed across the United States is significant, and decreasing that variation through use of software and digital control of information can have a tremendous impact on costs, Fitzgerald said.

“From a diagnostic standpoint, we need to decrease the variability of how we triage patients,” he said. “Once you’re in treatment, we need to decrease that variation, [as well].”

Computational algorithms provide invaluable information that helps doctors diagnose patients and finalize a decision plan before a patient gets to the cath lab.

An estimated 20,000 health care apps exist for smart phones, and that number is expected to quadruple by the fourth quarter of 2013. Electrocardiograms can be performed on iPads that transmit information to nurses and physicians.

The field of robotics also is experiencing rapid growth.

More than a million robotic surgical and hybrid interventional techniques are expected to be in use by 2015, Fitzgerald said. The consistency they provide in the operating room offers countless benefits, including reductions in infection and transfusion rates, he said.

Finally, the digitization of information that has revolutionized the consumer industry will move into medicine quickly, Fitzgerald said.

“We don’t do a great job in medicine with respect to information,” he said. “If you told me 5 years ago you’d be doing your banking on your cell phone, I’m not sure I would have believed it. But we trust our dollars, why not trust medicine?”