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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
