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INNOVATION AND
HEALTHCARE REFORM
David Noble MBBS FANZCA
www.bdihealth.com
WHAT IS INNOVATION
Innovation is the practical (commercial) application of an
invention or novel idea (product, service, process)
The light bulb was research and development; the power
grid allowed the practical application
Research might be cool science but it is
commercial application that pays the bills
www.bdihealth.com
AUSTRALIAN HEALTHCARE
“The Australian Healthcare sector is arguably one of the
largest cottage industries in the southern hemisphere”
Cottage Industry: a small and often informally organised industry that lacks
the coordination and discipline of business
www.bdihealth.com
WHAT IS BDI HEALTH?
COMBINING CLINICAL PRACTICE WITH CLINICAL TRANSLATION
 Clinical Practice
 using skills, knowledge and existing products, services or processes to treat patients today
 Clinical Translation
 using skills and knowledge and resources to develop and deploy new healthcare products, services or processes
for tomorrow
 Healthcare technology development
 Medical hardware
 3 commercial development grants $110k
 Clinical translation “pipeline” with UK and US entities for hardware and software development
 Healthcare technology deployment
 Adviser to IBM Smarter Healthcare Solutions
www.bdihealth.com
WHAT IS ANAESTHETICS
The delivery of real time, hyper-dynamic
multisystem risk/benefit analysis and actions
constrained by existing governance and
process mechanisms
www.bdihealth.com
THE HEALTHCARE ECOSYSTEM
The delivery of real time, hyper-dynamic
multisystem risk/benefit analysis and action
opportunity modified by continuously evolving
governance and process mechanisms
www.bdihealth.com
Why should anybody care?
www.bdihealth.com
GRATTAN INSTITUTE APRIL 2013
“Time to face rising pressures on Australian government budgets”
 The report finds that the greatest of the pressures that put Australia’s prosperity at
risk come from sustained growth in spending, especially health expenditure, which
rose by nearly $42 billion in real terms over the past decade.
 But contrary to widespread belief, it is not the ageing population that is driving
health spending but the fact that people of all ages are seeing doctors more often,
having more tests and operations and taking more prescription drugs.
www.bdihealth.com
HOW GOVERNMENTS RESPOND TO FINANCIAL
IMBALANCE
 Increase in taxation
 Reduction in services
ALL OF THESE HAVE A NEGATIVE IMPACT
ON FINANCIAL PROSPERITY
Traditional methods will not fix the system… but that never
stopped them before
www.bdihealth.com
WHO MAKES THE BIG BUCKSTHE AGE MAY 2013
1. Surgeon- $350,383
2. Anaesthetist- $302,653
4. Internal Medicine- $254,597
6. Psychiatrist- $176,885
9. Other medical- $155,465
10.Dental- $140,957
www.bdihealth.com
WHERE DOES THE HEALTHCARE $ GO?
 25%-40% of the healthcare budget is lost as “waste”
 60% of a hospital’s expenditure is on wages
www.bdihealth.com
AN ARGUMENT FOR CHANGE
IT IS POSSIBLE THAT GOVERNMENTS WILL SOON BE ARGUING
THAT THE MEDICAL PROFESSION IS THE PROBLEM AND NOT THE
SOLUTION TO THE HEALTHCARE CRISIS
INCOME WILL BE A SIGNIFICANT FACTOR
www.bdihealth.com
THE WRITING IS ON THE WALL
 Performance-based funding
 Change in workforce dynamics
 More medical graduates to increase competition
 Insufficient places for current graduates
 Increasing anaesthetic trainee numbers to alter supply/demand ratio
 No staff jobs in major cities and departments being downsized
 Introduction of Nurse Practitioners
 Perioperative specialists
 Other specialties including general surgery
 Session rate is $400
The only laws that can’t be changed are the laws of nature
Look what happened to the bank deposits in Cyprus
www.bdihealth.com
IF WE WANT TO SURVIVE WE NEED TO SEEN AS PART OF THE
SOLUTION AND NOT JUST PART OF THE PROBLEM
DO WE ACCEPT THEIR PATH OR CHOOSE
OUR OWN?
www.bdihealth.com
PART OF THE SOLUTION
ONE OPTION IS TO BECOME CLINICAL
TRANSFORMATION SPECIALISTS IN ADDITION
TO CLINICAL PRACTICE SPECIALISTS
www.bdihealth.com
AN EXAMPLE OF CLINICAL TRANSLATION
 As anaesthetists we acts as clinical specialists
 If we use our skills and knowledge to develop and deploy new products,
services and processes then become clinical translation specialists
 If those products, services or processes improve patient outcomes and
decrease total healthcare costs then they improve the financial balance in
healthcare
 If the new products, services or processes have commercial potential then
they can be exported and improve national prosperity
 If we have a stake in it we make $$
www.bdihealth.com
COMMERCIAL HEALTHCARE REFORM
Improved patient outcomes
Decreased total healthcare costs
Develop export driven healthcare economy
www.bdihealth.com
EXPORT DRIVEN HEALTHCARE ECONOMY
 New Zealand has made a commitment to double medical technology exports
between 2012 and 2015
 What are the roadblocks to Australia achieving something similar?
The roadblocks are cultural and not technical or
geographical
THE END

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Innovation and Healthcare Reform

  • 2. www.bdihealth.com WHAT IS INNOVATION Innovation is the practical (commercial) application of an invention or novel idea (product, service, process) The light bulb was research and development; the power grid allowed the practical application Research might be cool science but it is commercial application that pays the bills
  • 3. www.bdihealth.com AUSTRALIAN HEALTHCARE “The Australian Healthcare sector is arguably one of the largest cottage industries in the southern hemisphere” Cottage Industry: a small and often informally organised industry that lacks the coordination and discipline of business
  • 4. www.bdihealth.com WHAT IS BDI HEALTH? COMBINING CLINICAL PRACTICE WITH CLINICAL TRANSLATION  Clinical Practice  using skills, knowledge and existing products, services or processes to treat patients today  Clinical Translation  using skills and knowledge and resources to develop and deploy new healthcare products, services or processes for tomorrow  Healthcare technology development  Medical hardware  3 commercial development grants $110k  Clinical translation “pipeline” with UK and US entities for hardware and software development  Healthcare technology deployment  Adviser to IBM Smarter Healthcare Solutions
  • 5. www.bdihealth.com WHAT IS ANAESTHETICS The delivery of real time, hyper-dynamic multisystem risk/benefit analysis and actions constrained by existing governance and process mechanisms
  • 6. www.bdihealth.com THE HEALTHCARE ECOSYSTEM The delivery of real time, hyper-dynamic multisystem risk/benefit analysis and action opportunity modified by continuously evolving governance and process mechanisms
  • 8. www.bdihealth.com GRATTAN INSTITUTE APRIL 2013 “Time to face rising pressures on Australian government budgets”  The report finds that the greatest of the pressures that put Australia’s prosperity at risk come from sustained growth in spending, especially health expenditure, which rose by nearly $42 billion in real terms over the past decade.  But contrary to widespread belief, it is not the ageing population that is driving health spending but the fact that people of all ages are seeing doctors more often, having more tests and operations and taking more prescription drugs.
  • 9. www.bdihealth.com HOW GOVERNMENTS RESPOND TO FINANCIAL IMBALANCE  Increase in taxation  Reduction in services ALL OF THESE HAVE A NEGATIVE IMPACT ON FINANCIAL PROSPERITY Traditional methods will not fix the system… but that never stopped them before
  • 10. www.bdihealth.com WHO MAKES THE BIG BUCKSTHE AGE MAY 2013 1. Surgeon- $350,383 2. Anaesthetist- $302,653 4. Internal Medicine- $254,597 6. Psychiatrist- $176,885 9. Other medical- $155,465 10.Dental- $140,957
  • 11. www.bdihealth.com WHERE DOES THE HEALTHCARE $ GO?  25%-40% of the healthcare budget is lost as “waste”  60% of a hospital’s expenditure is on wages
  • 12. www.bdihealth.com AN ARGUMENT FOR CHANGE IT IS POSSIBLE THAT GOVERNMENTS WILL SOON BE ARGUING THAT THE MEDICAL PROFESSION IS THE PROBLEM AND NOT THE SOLUTION TO THE HEALTHCARE CRISIS INCOME WILL BE A SIGNIFICANT FACTOR
  • 13. www.bdihealth.com THE WRITING IS ON THE WALL  Performance-based funding  Change in workforce dynamics  More medical graduates to increase competition  Insufficient places for current graduates  Increasing anaesthetic trainee numbers to alter supply/demand ratio  No staff jobs in major cities and departments being downsized  Introduction of Nurse Practitioners  Perioperative specialists  Other specialties including general surgery  Session rate is $400 The only laws that can’t be changed are the laws of nature Look what happened to the bank deposits in Cyprus
  • 14. www.bdihealth.com IF WE WANT TO SURVIVE WE NEED TO SEEN AS PART OF THE SOLUTION AND NOT JUST PART OF THE PROBLEM DO WE ACCEPT THEIR PATH OR CHOOSE OUR OWN?
  • 15. www.bdihealth.com PART OF THE SOLUTION ONE OPTION IS TO BECOME CLINICAL TRANSFORMATION SPECIALISTS IN ADDITION TO CLINICAL PRACTICE SPECIALISTS
  • 16. www.bdihealth.com AN EXAMPLE OF CLINICAL TRANSLATION  As anaesthetists we acts as clinical specialists  If we use our skills and knowledge to develop and deploy new products, services and processes then become clinical translation specialists  If those products, services or processes improve patient outcomes and decrease total healthcare costs then they improve the financial balance in healthcare  If the new products, services or processes have commercial potential then they can be exported and improve national prosperity  If we have a stake in it we make $$
  • 17. www.bdihealth.com COMMERCIAL HEALTHCARE REFORM Improved patient outcomes Decreased total healthcare costs Develop export driven healthcare economy
  • 18. www.bdihealth.com EXPORT DRIVEN HEALTHCARE ECONOMY  New Zealand has made a commitment to double medical technology exports between 2012 and 2015  What are the roadblocks to Australia achieving something similar? The roadblocks are cultural and not technical or geographical