Innovation in Health: Challenges and Opportunities

Innovation is one of the major challenges in Healthcare. This topic was discussed in the II Conference of the Innova ICAI forum "The future of Healthcare: Challenges and Opportunities for innovation and Entrepreneurship". Many healthcare professionals, CEOs of successful start-ups and other engineering representatives attended this workshop on the 12th of May 2022.

One of the most interesting presentations, which we summarize in this article, was delivered by M. Javier Colás, president of Additum and former vice-president of Medtronics Europe.

M. Colás explained how in the last 25 to 30 years medicine and engineering are converging. The introduction of tech innovations into the health systems has succeeded in making deadly diseases now chronic.

There are 5 specialized areas of medicine, known as the 5 P´s, that will improve healthcare and not just clinical treatment. These are:

• Personalized medicine. It is based on genetics and helps predict what will be best to treat a pathology that has manifested
• Preventive medicine. It refers to the necessary recommendations to avoid pathology.
• Predictive medicine. Combining the two above, it achieves early detection of pathologies.
• Precision medicine. Based on more precise treatments for diseases.
• Population medicine. It allows better management of the general risks of populations, as what has happened with the Covid-19 pandemic.

Thanks to these innovations, by 2030 we will generate 4 times more health than can be generated now.

The main problem resulting from this increase in innovation is the higher cost of the healthcare system. In 2030 there will be no budgetary capacity four times greater than what we have today. Therefore, the key challenge to be solved by engineering is to reduce the cost of the healthcare system or at least to keep it not much higher than today. We must be able to improve the system organization so that budgets do not have to be multiplied.

One of the good things that engineering can bring to the healthcare sector is finding solutions that create value. Once an unsolved problem is identified, be it clinical, organizational, or information management, we need to be able to develop technological solutions that can help create value.

Creating value is not generating knowledge to implement new treatments or improve existing ones.

"Value is created when the system is managed efficiently so that the number of treatments or interventions to be performed is as small as possible."

The right approach is to manage end-to-end medical processes, in their full scope, not only when the critical case comes. This is why technology in  healthcare should consider not only the application of engineering or science to achieve effective treatments. It also has to do with the activation of the patient and a more efficient organization of the healthcare system.

Innovation through value creation in clinical processes

"If we want to create value in many clinical processes, we need to move the focus beyond the critical part of the process"

Some examples in different pathologies:

• In the case of stroke, detecting the problem in time is as important or more than applying a scientific solution to extract the thrombus. Less than 50% of stroke patients arrive alive at the hospital, and only 35% of them are treated. There is a time window when treatment is most effective; after that time treatment is much less effective and the patient’s risk increases.
• With diabetic foot, the best therapy from engineering can provide is to help prevent amputation. Spain is one of the countries with the most foot amputations, being the social cost of an amputated foot between 40.000 - 50.000 €. It is necessary to work to prevent the patient from becoming diabetic type 2, and look after the foot to reduce amputations.
• In the case of breast cancer, both treatments and screening systems have improved a lot. However, 30% of patients do not follow screening. Patients need to attend screenings to detect the problem early and avoid the problem getting worse.
• For dialysis, in addition to educating patients in prevention, the monitoring of adherence to treatment is key to delay the entry into dialysis for a few years. A dialysis treatment costs about €46.000 a year so a hospital with 500 patients could save €46 million delaying dialysis for 2 years.

According to M. Colás "Every pathology has different challenges and opportunities; Some related to science, many related to patient activation, and many others related to the efficiency of the processes in which engineering is used". 

All the innovations around predictive, preventive, personalized, precision and population medicine cannot be implemented if we are not able to optimize the system organization so that budgets do not have to be multiplied by 4. That is why achieving better efficiency is key. Not so much to solve clinical problems, but to be able to pay for the innovations that appear.

Innovation for a sustainable healthcare system

Circular economy is a great opportunity for entrepreneurship in healthcare. This sector is responsible for about 4.7% of CO2 emissions. The reduction of the carbon footprint and meeting the goal of 0 emissions open up a range of new opportunities for engineering. 

70% of emissions come from the supply chain, that is, the production, transport, use and management of waste associated with pharmaceuticals, chemicals, medical and hospital equipment and instruments.

The project of the first green oxygen and hydrogen plant in the Viamed hospital in Murcia (Spain) is a good example. As explained by ennomotive in this news, the on-site generation of medical supplies or gasses has a positive impact on the reduction of the carbon footprint. One simple reason is to remove the need to transport these gasses. In addition, natural gas can be replaced by hydrogen for heating and air conditioning. This project will help reduce the hospital’s carbon footprint by approximately 25%; heating with hydrogen alone will reduce more than 40 tons of CO2 emitted per year.