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10 Innovations That Will Transform Medicine ... Harvard Business Review


This post is part of Harvard Business Review's Health Care Innovations Insight Center...

Here are excerpts from the 10 innovations that Harvard Business Review thinks will have a big impact ...



1. Checklists Health care is catching on to something pilots have known for decades — that by taming complexity, checklists can save lives. In his best seller The Checklist Manifesto, surgeon Atul Gawande describes how using a simple checklist before surgery can help hospitals catch stupid mistakes before
they happen (are we operating on the right patient?), reducing deaths nearly half. A checklist tested at Johns Hopkins Hospital required doctors to confirm, among other things, that they'd washed their hands before inserting a central line. Incredibly, when doctors used the list, the 10-day line-infection rate fell from 11% to zero...

2. Behavioral Economics ... Behavioral economics tools —gentle prods that nudge us to behave in desired ways — may be more effective than any amount of browbeating by doctors. In a recent HBR blog, John Sviokla and colleagues described how reminders, social pressure, default options, rewards, and other behavioral tricks can be used to improve compliance in stroke and diabetes patients and, surely, anyone else who drops the self-care ball from time to time ...

3. Patient Portals ... Patients could log on to their own secure portal, access and share their medical
records, check lab results, renew prescriptions, deal with insurers, and communicate with doctors and nurses. In fact, there are many such patient portals up and running or in the works, Microsoft HealthVault and Google Health ...

4. Payment Innovations "If automakers were paid by the bolt, cars would be brimming with bolts," Harvard Medical School professor Jeff Levin-Scherz writes in the April 2010 Harvard Business Review. In the U.S., we pay for health care "by the bolt," shelling out for units of service rather than results, rewarding volume over value, and encouraging extra visits, procedures, and tests ... Other models offer doctors monetary incentives for keeping their patients healthy ...

5. Evidence-Based Decision Making It's unsettling to be reminded that doctors' decisions aren't always (or even usually) evidence-based ... Electronic medical records offer one way to help align what doctors do
and what the best evidence says they should do.

6. Accountable Care Organizations ... imagine an organization whose job was to keep you healthy and out of the hospital, and actually rewarded its doctors and hospitals when they did. It's an idea that's generating a lot of buzz in Washington...

7. Virtual Visits ... it seems that televisiting your doctor will just be a matter of time. Judging from the ubiquitous Cisco ads, in which Ellen Page televisits her doctor in Denmark from Nova Scotia, that time is
(virtually) here. Cisco has tested its technology in the U.S. and abroad, and launched a new commercial system this month. MedTech-IQ member Ronald Dixon, director of the Virtual Practice Project at the Massachusetts General Hospital, has found that doctors and their patients readily take to televisiting ...

8. Regenerative Medicine ... Stem cells, which can transmute into any type of tissue — muscle, liver,
bone, what have you — can potentially cure an array of devastating, once intractable conditions, from cancer to multiple sclerosis to spinal cord injuries... There's every reason to be optimistic about the prospects for stem cell therapy, but the devil is in the details.

9. Surgical Robots ... surgical robots promise to help surgeons squeeze into tight places, performing minimally invasive repairs that, in theory, should lead to better outcomes ... Robots will become increasingly common (and expected) in ORs — yet it may be years before we know how well they work.

10. Genetic Medicine ... It's wise to avoid the terms "holy grail" and "breakthrough" in discussing any therapy. But, truly, both apply to attacks on disease at the gene level. There are two big ideas here: One is to replace defective genes with working ones; the other is to tailor drug treatment to your specific genetic profile, creating customized cures ...

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Comment by CC-Conrad Clyburn-MedForeSight on March 28, 2010 at 4:28pm
Sometimes transformational change is cultural, rather than technical. I would put 'Checklists" in the category. Would you agree? Frequently it is the human dimension that is the most important element that enables or prevents fundamental change...
Comment by Parvati Dev on March 25, 2010 at 1:21am
Amazing that a concept such as checklists should have such a huge impact on patient safety in hospitals!


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