This document discusses innovation in healthcare through research-based design and evaluation tools. It covers lessons learned from initiatives aimed at improving healthcare through innovation, including: - Translational research centers that integrate clinical, research, education and technology functions can help move discoveries from the lab to patient care more quickly. - Co-locating specialties and supporting "convergence" of disciplines can accelerate innovation by breaking down silos. - Flexible "kit of parts" designs that allow centers to evolve over time better support disruptive technologies.

1. Health Improvement through Innovation Session 4: Research-based Design: An Evaluation Tool for Improving Healthcare 7th World Congress

2. A The Promise of Innovation How Facilities Impact Innovation Lessons from HDR’s Translational Health Science Initiative

3. Introduction: in·no·vate [in-uh-veyt] verb to introduce something new; make changes in anything established. generally refers to the creation or improvement of products, technologies, or ideas “Appreciative Inquiry (AI) as a systematic discovery of what gives life to a living system (ie. in our case an organisation) when it is most alive, effective and constructively capable.” D. Cooperrider “We can’t solve problems by using the same kind of thinking we used to create them” -A. Einstein “medicine is not a science: it is the clinical practice of healing the given individual” -Wikipedia

5. HIM pervasive use in development of Best Practice - EBM - Comparative Effectiveness

6. Transition from the primacy of the Patient - Physician relationship via Care Extenders

7. “Reorganization of Primary Care as Disruptive Innovation: From Molecules to Practice - HIT and the Medical Home” CIMIT4

8. The Threat of Innovation – Dr Tim Johnson The Theory of Translation The View Friday Nov. 5th 2010 “The biggest threat to our Healthcare industry is the blatant introduction of expensive unproven technologies” “If we don’t bend the cost curve we’ll be bankrupt in 8 years”

9. 100% I H E A L T H S T ATUS I 0% Birth Projected human life span 120 Years

10. The Square Wave Life Curve 100% I H E A L T H S T ATUS Jeanne Louise Calment Photo by N'geenTien-Gamma Liasion I 0% Birth Projected human life span 120 Years

11. TGP’s Value Proposition: The Patient Personalized Medicine Partners Patients Researchers Predisposition analysis with behavior modification and exposure avoidance Achieve a molecular diagnosis 4 1 Parental carrier screening and reproductive decisions for monogenic disease 2 Ongoing research results returned to clinical practice to improve patient care 5 Ongoing relationship that will improve decision heuristics and improve care 6 Earlier and more appropriate interventions 3 CHB Catchment Age Impact (Ages 0 – 21) DNA Sequencing, Initial Results Return, Conduct Research, Ongoing Results and Patient Re-engagement, Impact Practice of Clinical Care CHB Ongoing Care Impact (Ages 21 and over) Conduct Research, Ongoing Results Return, Family Re-engagement, Impact Practice of Clinical Care Diagnosis and Familial Carrier Status Post-Disease Management Predisposition, Environment, and Pediatric Care Management Interaction with Primary Care Provider Interventions and Adult Care Management

12. Patient Care Paradigm Whole Body Organs and Systems Cells and Tissue Genes and Molecules

13. b How Facilities Impact Innovation Medical Arts Intuitive Medicine Multidisciplinary Specialists Experience Evidence - Based Medicine Knowledge Technologists Precision Medicine Medical Science

14. Disruptive Technologies to Meaningful Use The Theory of Translation Device Data Transmission Steam Engine Medical Records Wireless Core Enabler Wired Communication Virtual Grid Rails TCP-IP Innovation Health Information Exchange Social Networking High Speed Train Video Conferencing

16. Advanced Multimodality Image Guided Operating (AMIGO) Suite Disruptive Technology Connected Modular Procedure Rooms = Laboratory PET/CT Fluoroscopy, US, Optical MRI Robotics, Navigation, Mass-Spectrometry, Histology

17. “Strange Attractors…deal with the rich and diverse types and sources of information which could potentially inform decisions” G.R. Gates MRI Optical probes Gamma probe Beta probe In vivo imaging In vivo spectroscopy PET Histology MRI PET Navigation Pathology Ex vivo spectroscopy Validation of Multimodality Imaging Disruptive Technology

18. c Lessons Learned from HDR’s Translational Health Science Initiative

19. Translational Health Science Center Design Kit of Parts Clinical Trial Intervention Patient Care Hospital | Out-Patient Care Lab Translational Zone Bioinformatics Research & Development Faculty | Classrooms Medical Education Simulation Vivarium

20. Translational Facility Typology The Evidence of Translation Single Organ / Disease Specialty Transdisciplinary Integration Multiple “Centers of Excellence” KnowledgeTransfer KnowledgeTransfer Mechanical Mechanical Mechanical Laboratory Clinic Hospital Office Clinic Laboratory Office Hospital Clinic Office Office Laboratory Hospital Support / Technology Support / Technology Support / Technology Laboratory Clinic Hospital Med Ed / Outreach Amenity / Interaction Clinic Hospital Laboratory Vivarium Core Tech Core Tech

21. Vertical Integration to Horizontal Integration The Evidence of Translation Inpatient Research & Admin Diagnostic & Treatment Research Ambulatory

22. MEEI Research Building

23. The “Pike” Brigham and Women’s Hospital

24. VISION | MID-CAMPUS EXPANSION Brigham and Women’s Hospital Future Site of Patient Tower AMIGO Suite BWH Cardiovascular Center New 350,000 sf Translational Research Building

25. Delivering on a Concept iPad? iPhone? What device made by Apple has had the most disruptive impact on the handheld industry? Newton! The Newton, which failed because it was technology without application