Putting medics at the heart of innovation

Jim Roberts, PDD Independent Advisor in Healthcare Innovation shares his thoughts on the importance of putting medical professionals at the heart of technological developments. 

During the COVID-19 outbreak, healthcare professionals had to adapt to a quickly evolving situation by being innovative and agile. For example, the medics themselves at one NHS Trust hospital worked with Mercedes AMG to re-engineer hospital oxygen face mask systems, helping to reduce oxygen consumption by 30%. By reducing the oxygen consumption by this amount, the hospital was able to keep functioning without a fundamental reconfiguration of oxygen delivery which would have proven impossible during the crisis.

The same hospital also deployed Formula One pit crew communication technology to allow medical teams to communicate with each other while wearing full PPE. Additional innovations included the creation of custom lightweight and comfortable full-face visors that gave additional protection against aerosol generating procedures and the creation of a new National COVID tracheostomy protocol.

These experiences, among others, have led to medics reflecting on why they aren’t more closely involved in the design and development of the products they use every day. The pandemic showed the invaluable contribution medics can offer to innovate and streamline healthcare systems, so with this learning, how can we harness their expertise to create better and more effective products?

Having worked in the NHS as a consultant anaesthetist for 16 years, with a real passion for medical equipment and innovation, there’s a huge opportunity for the development of better products and we cannot underestimate the value and expert insight medics can bring here.

Once, medical instruments commonly bore the name of their inventor, which would imply that that individual was closely associated with the development cycle of that product, such as the Macintosh Laryngoscope and the Magill Forceps. Now, we as users within the medical community are no longer involved in that design process, and we tend to work with what we are given. 

Medics are typically also not the purchasers of equipment in our current procurement pathway or part of this decision-making process, which means that the normal commercial feedback loops are disrupted. This pushback on industry is therefore absent, and it is here that a great opportunity is lost. A drop of oil here, on this cog, would harness not only the feedback of healthcare professionals and patients to refine products, but catalogue unmet needs and harvest the truly new innovative ideas too. 

But there are specific challenges stopping this vision happening:

A linear process with minimal touchpoints

First, a typical medical product development process is linear. A clinical need is identified, often, but not always, with medics involved to help shape initial product requirements. Then the product is designed and manufactured with the bare minimum of input from those same medics. 

The next touchpoint medics encounter is often right at the end of the process, where there is a binary consumer choice to purchase or not to purchase the finished product. As hospital procurement departments very often decide this anyway, the medics face the situation of getting what they are given.

The disconnect between the medic and the company selling the product denies the opportunity for meaningful feedback, ensuring the shortcomings of existing and recently launched products are not overcome or mitigated against the next time round.

Medics aren’t product developers

Unsurprisingly, healthcare professionals aren’t design professionals. But even if they had the requisite skills and facilities to bring an idea to reality, there are many other challenges that stop medics coming forward with product innovations:

• Everyone is too busy working and clearing waiting lists, so any ambitions to improve products must be done in one’s own spare time.
• There is no support structure in most healthcare systems to help medics bring their innovations to market, or even to a basic conceptual or prototype level for evaluation.
• Medics have no visibility of internal research & development budgets.
• A lack of successes to draw inspiration from in recent years means that those who have tried to develop innovations in the past have failed, deterring others from trying.
• In the UK, any intellectual property (IP) generated by medics belongs to the NHS. IP costs money to create, maintain and defend which might be better spent developing proof of concept at this earliest germination stage. The emphasis should be on the process of design science rather than simply trying to define a future product and building its business case

Inertia in the system

Essentially, healthcare systems are not built to be product innovation hubs. They are in the business of treating patients and rely on industry to supply a stream of fit-for-purpose products to aid that cause. 

The problem is one of inertia: Bringing products to market is a long and arduous process, so the barriers to entry have resulted in a small monopoly of companies selling the same products with little competition. Paired with procurement departments making ever more constrained financial decisions (sometimes against clinical visibility and advice), then you have a perfect storm where professional products are sold to professionals without involvement or buy-in.

Is there a solution?

There is a better way. The solution lies in defining better partnerships between medics, healthcare systems and industry, combined with a process of development which puts medics at the heart of an iterative innovation cycle.

First of all, a partnership mechanism where medics, healthcare systems and industry come together to converse, understand each other’s needs and create conditions for the free flow of information is paramount. But how might this look in reality?

It starts with a sponsor – an entity to align stakeholders under a commercial framework in terms of funding and IP. That sponsor might be a charity, philanthropist, hospital, or industry. 

Then, roles and responsibilities would be drawn up and key questions asked– who are the key stakeholders? Are intermediaries involved, like product innovation consultancies such as PDD, who are adept at framing the challenge and steering the development in the right direction? is the decided area of innovation driven by the sponsor, or industry or the medics themselves?

Finally, the process itself is ripe for innovation. Rather than the linear approach described above, we propose a circular, iterative development process. One where medics are embedded right the way through to help write the brief, explore opportunities, ideate solutions, test, and iterate prototypes, evaluate final products, steer procurement decisions and catalogue opportunities for future products. 

Conclusion

To involve those who use the tools to help develop the tools is sheer common-sense. Medics who were empowered to make innovative decisions during COVID are actively seeking ways to rekindle that spirit in more “normal” times. It is up to the healthcare systems to give them the support they need to achieve this, and for industry to engage with medics to deliver better products through an integrated process like the one we have proposed.