disruptive versus incremental innovation in healthcare … twitter/medicalfutures andy goldberg md...
TRANSCRIPT
Disruptive versus incremental innovation in healthcare…
twitter/medicalfutures
Andy Goldberg MD FRCS(Tr&Orth)Consultant Orthopaedic Surgeon
Royal National Orthopaedic Hospital NHS Trust
Deputy Director R&DUCL Institute of Orthopaedics & Musculoskeletal Science
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
?Better?
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Market cap $340BnLargest company in the world
T/o - $65Bn, $14Bn Profits Making it 111th company in size
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Market cap $340BnLargest company in the world
T/o - $65Bn, $14Bn Profits Making it 111th company in size
T/o $350Bn with $30Bn Profits
Disruptive Technology
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Everett Rogers, Professor of Rural Sociology, Iowa (Rogers, Everett M. (1962) Diffusion of Innovations)
Adoption of Innovation
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Everett Rogers, Professor of Rural Sociology, Iowa (Rogers, Everett M. (1962) Diffusion of Innovations)
Adoption of Innovation
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Everett Rogers, Professor of Rural Sociology, Iowa (Rogers, Everett M. (1962) Diffusion of Innovations)
JVC VHS
Sony’s BetaCam
Adoption of Innovation
Adopter’s willingness to
participate
AwarenessInterestEvaluation (evidence base)Tendency to risk
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Adopter’s willingness to
participate
AwarenessInterestEvaluation (evidence base)Tendency to risk
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Uncemented Hips
MeyerBurutaranL.S Barouk
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Uncemented Hips
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Uncemented Hips
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
Uncemented Hips
Stepwise Introduction
of Technology*Preclinical TestingFirst In ManClinical TrialsPost Market Surveillance
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
* Malchau 1995 (modified)
Stepwise Introduction
of Technology*Preclinical TestingFirst In ManClinical TrialsPost Market Surveillance
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
* Malchau 1995 (modified)
– FDA & MHRA
Are we joined up?
FDA/MHRAClinical GroupsNICEInsurers/CommissionersIndustry
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
* Malchau 1995 (modified)
New Proposal
Industry has commercial pressuresNHS funds research (circa £1Bn)Quid Pro Quo
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
* Malchau 1995 (modified)
New ProposalNew Technology Panel (composed of stakeholders (ie regulators, clinicians, commissioners, industry and patients)
Identify what evidence could be developed at the outset
Joint funding of research (NHS & Industry)
Limited marketing authorisation granted to industry (to trial centres who pay for product)
Full marketing authorisation granted after agreed time period
Andy Goldberg MD FRCS(Tr&Orth)www.medicalfutures.co.uk
