Once our clinical immersion in Hospital Sant Joan de Déu ended, far from the warm of healthcare professionals we find the chilliest wind ever. Short after discovering unmet clinical needs was time to filter them. We classified the 400 observations … Continue reading
The hard-working health care professionals we have today get a lot of help from amazing medical devices. The doctors, nurses and others from more than a century ago — and especially those from more than two centuries ago — would be amazed at the things that we can do in health care today. No matter your health care specialty, you have probably benefited from medical innovations.
Recently Qmed surveyed its audience about their thoughts on what are the most important medical devices ever developed. At the top it was the hypodermic syringe. Along with the myriad of substances for which they are the prime, if not the only, delivery vehicle, have probably been responsible for saving more lives and alleviating more suffering than any other piece of medical technology. Completed the list the pacemaker, the eyeglasses, the X-ray machine, the MRI, the stethoscope, the band-aid, the catheter, the CT Scanner, the cochlear implant, the intraocular lenses and the heart valves.
Innovation within the medical device industry had led to tremendous advances in the provision of care for patients worldwide. But it is a process that needs to continue.
Our mission in Design Health Barcelona (d·HEALTH Barcelona) program is to train the next generation of healthcare innovators, the ones that will invent and implement the new biomedical products, through the biodesign process, a systematic approach based on unmet needs finding to later increase our ability to diagnose and treat conditions.
We are currently seeking the fellows for d·HEALTH Barcelona 2014-2015. Worldwide youngsters with interest in the development of medical technologies and with advanced degrees in engineering, design, business or life sciences are encouraged to apply before May 11, 2014.
We offer the fellows a once-in-a-life-time experience, first hand access to real-world experts from the medical technology, legal and venture capital sectors worldwide and a fun learning/working environment while they join an emerging field.
d·HEALTH Barcelona 2013-2014 fellows are currently prototyping their innovations. Will one of them join, in the future, the list of greatest medical devices ever? Or will be yours, future fellow reading this post? Only time will tell. Meantime, if you want to get more info about the application process or, even better, apply and become a member of our red polo shirts team, click here.
“Some patients told me they got used to not being able to use their legs. Not having bladder-control is what really affects their quality of life. These statements really changed my point of view” recalls Markus. He is a d·HEALTH Barcelona fellow and, for the last 4 weeks, he has been immersed with his team at Institut Guttmann, a centre specialized in neurorrehabilitation.
Markus’ reflection resumes what discovery is about: being in the right place at the right time but also about being receptive to new ideas and opportunities when they arise. Through the clinical immersion stage, the Design Health Barcelona program challenges its’ fellows to find and address new opportunities for innovation based on clinical needs.
Identifying and understanding clinical challenges and problems that impose a significant medical burden is the first step to later develop novel solutions. Finding them it may seem simple and obvious, but it is not. The identifying process is a profound experience that requires innovators to use observation skills and find new ways of looking at procedures and events at hospital settings.
Since 1st November, d·HEALTH Barcelona fellows, divided into three teams, are immersed in three different clinical environments: the Thorax Clinical Institute at Hospital Clínic, the neurorrehabilitation specialized Institut Guttmann and the neonatology area at Hospital Sant Joan de Déu.
“It is curious how many procedures are done without considering if they are the most efficient way. The hectic schedule leaves to physicians little time to rethink the methodologies they have been implementing for years” say Lalis, Mateu, Roger and Alfred, the team of fellows working at the Hospital Clínic.
The healthcare system offers fertile ground to search for unsolved problems. To detect them, innovators must try as much as possible to become integral part of the group being studied to understand the perspective of the “insiders”. “What I did is to be a doctor’s shadow the first week, follow him/her with few or no questions, just listening and observing and after some days, once I had the basic knowledge and a first-hand insight to the problems and conflicts doctors face, start questioning. This, with lots of patience, observation and a proactive attitude allowed me to identify clinical needs” explains Arnau, immersed at the Neonatology unit at Hospital Sant Joan de Déu.
To get into the mindset of the people delivering (or receiving) treatment to thoroughly understand the circumstances requires substantial time and energy. For example, if an innovator is seeking to identify the problems associated with the use of a device in a certain surgical procedure, he/she needs to arrive at the hospital when the surgeon does, watch several unrelated cases and the observe the entire procedure and the post-operative routine.
“It’s amazing the amount of devices they use and the ease with which physicians handle complex situations such as a heart attack! It is very interesting to be on the other side and to see the disease from another perspective” says the team at Hospital Clínic.
All of the observer’s senses have to be focused on identifying issues or problems that have never before been seen or noticed. Because one never knows when these types of trigger may occur an open-mind and multiple levels of observations are essential.
“The first day I saw a patient with no mobility in the arm due to spasticity. A month later he had regained a lot. I remember therapist’s face showing the emotion for the progress!” remembers Marc at Guttmann Institut. “Before immersing at Guttmann I knew that an accident can change your life forever but I was not really aware of the many needs that remain unsolved to improve the quality of life and facilitate integration of the spinal cord and brain injuries” adds Imma.
d·HEALTH Barcelona teams will spend eight weeks performing intense, embedded observation activities. After that, in most cases, the idea flow slows down. A sign of this might be that there are fewer and fewer observations but a few others keep coming up repeatedly.
“We have already identified over 300 needs. We have not experienced a big “aha moment” yet but I believe we are on the right way. In the weeks ahead we expect to find more deep and valuable needs than the first ones that might be the obvious ones” says Marc, at Hospital Sant Joan de Déu.
“To be able to identify many needs these first weeks we have done an intense work of team building in a real environment and have received a lot of support from the professionals at Guttmann. Their collaboration is a key factor in our success” adds Angel.
When teams have identified viable clinical problems that seemingly now require to begin harvesting those ideas. When preparing to move on to the next step, it is always recommended to maintain good relationships with the patients, providers and representatives of the clinical setting who have been observed. Once a need statement has been developed and additional research performed, it will be necessary to return to the clinical environment to validate the need before concept generation begins. Having these relationships to leverage in the validation process is extremely helpful.
“Beyond the professional part, the clinical immersion is a very rich and very human experience” resumes the team at Hospital Clínic. “There is a clarity of mission and purpose in the healthcare setting often missing in the business world” adds Susan, at Hospital Sant Joan de Déu. “It feels good to be part of the process of helping people” ends Markus.
The goal of a startup is to find the right thing to build as quickly as possible. However, the vast majority of startups fail, that’s a fact. As a new research by Harvard Business School shows 75% of all start-ups don’t succeed. According to the researcher Shikhar Ghosh, startups fail not because the product is bad but because the market it is not adequate, it does not exist or it is insufficient, customers don’t buy therefore less revenue than expenses. The Startup Genome Project has also analyzed data from 3.200 companies and came up with some answers summarized in the following infographic:
Healthcare startups are among the ones that fail most. According to a study by University of Tennessee, 56% of startups in education and health still operate four years after launching.
The cost of startup failure in med tech is high: It throws away $10 to $200 million dollars, the time of 20 to 120 people, between 3 to 20 years of work and 3% to 25% of your life!
Recently, a couple of approaches have emerged that can make the process of starting a company less risky. The first one involves identifying unsolved problems because a well-characterized need is the DNA of a good innovation. This is what biodesign process is about, a needs-based invention process for medical device innovation aligned with an attractive market opportunity so that is sustainable. Developed by Stanford University in 2001, it has already launched 26 companies, raising over $200 million, creating over 500 new jobs and treating more than 150.000 patients.
The second approach that could reduce the failure rate of new ventures and help launch a new, more entrepreneurial economy, is a methodology called the “Lean Startup”. According to conventional wisdom, the first thing every founder must do is create a business plan, a static document that describes the size of an opportunity, the problem to be solved, and the solution that the new venture will provide. Typically it includes a five-year forecast for income, profits, and cash flow. Instead of executing business plans, operating in stealth mode, and releasing fully functional prototypes, young ventures based on the Lean Startup test hypotheses, gather early and frequent customer feedback, and show “minimum viable products” to prospects. This new methodology states that treating new ventures as established firms is a mistake.
d·HEALTH Barcelona has incorporated both approaches, biodesign and lean start-up, to its training process. Fellows will get immersed for eight weeks in a clinical setting, observe everything that happens and detect what does not happen, interact with professionals and with patients while working in a multidisciplinary team and learning about science, technology, business and design with internationally renowned experts and entrepreneurs. They will acquire the skills to select the best observed needs based on clinical impact, stakeholders, the treatment options and market’s characteristics to later build prototypes, present them in front of a panel of investors and get the funding to make them real.
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