In healthcare, we want fast innovation and instant implementation - but we also want our safety to be assured, and for our care to make sense financially. Sometimes it takes a national crisis to see just what is possible when it comes to moving quickly and safely toward medical solutions. The COVID pandemic, for example, helped us see the advantages of fast-tracking scientific innovation (a vaccine), but also showed us disadvantages (vaccine mistrust). In today's post, we'll explore 5 things to expect when trying to accelerate medical innovation, and in a future post, we will see how this national model of implementation and integration can be applied at the individual medical facility level, specifically, to infection control and prevention.
1. Accelerated innovation is usually motivated by an external pressure, often a crisis. The COVID pandemic accelerated the production of a vaccine through a worldwide collective effort and collaboration, just as World War II pushed us to form the National Science Foundation and National Laboratories, and the Cold War created an immediate need for NASA and DARPA. The publication of To Err is Human in 1999 and evidence that infections are preventable resulted in the addition of Medicare penalties in 2012. All of these have pushed the healthcare industry to accelerate innovations in infection control, from diagnostic tools to treatment protocols. What can we learn from these crisis-induced innovations, propelling us to fast-track new developments today? Just how did the world safely compress a vaccine’s time to patient use from 15 years to 1 year? Can we, as individuals, approach innovation the same way to make changes in our own hospitals?
2. The faster the pace of discovery, the greater attention the public places on the science. While most days, the general public doesn’t focus on the science behind innovation and breakthroughs (we tend to trust it and focus instead on the benefits of resulting technologies), rapid progress gets our attention!. This heightened awareness of the science tends to result in more elevated concerns while fears arise. This reaction has been seen over nuclear power, artificial intelligence, and most recently, mRNA vaccines. Without a firmer foundation in "the work of science" and an understanding of the massive body of work upon which these fast innovations are based, the non-scientist may experience mistrust, be vulnerable to misinformation, and ultimately oppose the technology outright, even when the benefits can be lifesaving. Therefore, the faster the pace of discovery, the greater the emphasis needs to be on educating the public about the underpinnings of these innovations, anticipating concerns, and providing forums for discussion and questions. The conversation must work to build trust in a wide range of audiences with varying concerns. What challenges do we face daily when it comes to adopting new technologies in our own facilities? When the scientific foundation is strong, how can we educate the doubters?
3. The pressure-cooker of a health crisis also can lead to strange, or at least unconventional, bedfellows. Institutions that might normally compete to reach a discovery first find themselves collaborating and sharing information towards a common goal. The global collaboration amid the private sector during the pandemic was unparalleled (a great podcast about this topic is here) Health care professionals participate in networks and working groups made up of individuals from across the medical fields, with doctors, data scientists, sociologists and engineers sharing findings and engaging in discussions that led to treatments, outreach messaging, and practical solutions. This type of science- and outcome-driven collaboration led to exponential leaps in innovations that could not have been achieved as isolated entities. Companies tore down walls of isolation and shared vital information, often sequestered outside of a crisis, in the interest of the common good and global health. Can we carry that methodology back into the day-to-day and model it at a facility level to improve patient outcomes? What can we learn from the “wisdom of crowds” and open dialogue?
4. One of the most significant obstacles to fast-tracking medical innovations is the time required to consume all the published research necessary to make a confident decision. When the right amount of statistically significant evidence exists to support adoption and implementation, that body of evidence is massive. Globally, amounts of data created and consumed worldwide has grown from 2 zettabytes in 2010 to 64.2 zettabytes just 10 years later. (1 zettabyte is 1021, or 1 sextillion, bytes. Or 1,000,000,000,000 GB.) While only a portion of that is dedicated to medical biosciences, everyone would agree that the volume of publications, reports, poster presentations, conference sessions, webinars and other media has multiplied exponentially. And it is overwhelming. We have to support trusted aggregators of information, curated by experts, and not affected by commercial interest - no "pay to play" directories where only those who contribute financially get their research promoted. The collaborative nature of shared best practices during the recent pandemic demonstrate how colleagues can communicate directly, bypassing corporate-controlled messaging and get directly to observed patient outcomes. While we don’t face one million million GB of information, it might as well be, it’s just as overwhelming. How can we apply the model of curated and trusted data on the individual facility level to make decisions faster? To get the best technology to the patients sooner?
5. The leap in innovation doesn't have to be a leap of faith when the science backs it up. Hospitals and facilities need not worry about being early adopters, when they have high-quality, unbiased data upon which to base their decisions. Unproven technologies, which may be heavily marketed but lack a foundation of peer-reviewed, published research, are understandably riskier. But new technologies who have checked all the boxes - bench science, clinical trials, regulatory steps, adoptions at facilities - but just at a faster rate are a decision facilities can make with confidence, even without knowing what the future will bring. How can we vet new technologies more efficiently, finding those with immediate value and a strong scientific foundation?
These five issues, as seen at a national scale, seem overwhelming and complex. In our next post, we'll explore these same five issues at a far more approachable level, the individual hospital or system. Join us as we answer some of the questions we’ve left unanswered above and until then, tell us what you think are some challenges facing fast-tracking innovation in your daily lives in the comment section below.