OMTEC 2017
David Kay, M.D.
Realities of Healthcare
Innovation
“Apple Proves That This Is The
Single Greatest Source Of
Innovation”
And everyone leans forward to listen
Lessons
Bad code is really bad
in healthcare
Underestimating the
complexity of healthcare
should be left to the
politicians
MY VANTAGE POINTS
• PRACTICING ORTHOPEDIC SURGEON
• SURGICAL SPECIALTY HOSPITAL OWNERSHIP - BILLING
COMPANY, PT, DME, MRI
• ACADEMIC - TEACHING, PUBLICATIONS AND PRESENTATIONS
• FOUNDER OF MULTIPLE MEDICAL-RELATED
COMPANIES WITH ACQUISITION
• MANY PATENTS - ISSUED AND PENDING
• KNOWLEDGE OF STRATEGY, MARGINS, QUALITY,
REGULATORY, LOGISTICS, SALES MANAGEMENT, ETC
• ADVISOR TO VENTURE FIRMS ON DILIGENCE
HEALTHCARE - DEFINITION
ANYTHING THAT HAS TO DO
WITH INDIVIDUAL/GROUP WELL BEING
Innovation - Definition
the action or process of innovating.
synonyms: change · alteration ·
revolution · upheaval · transformation ·
metamorphosis · breakthrough · new
measures · new methods ·
modernization · novelty · newness ·
creativity
INNOVATION -
Experts
WHY IS THERE INNOVATION?
• BECAUSE SOMETHING ISN’T
WORKING FOR SOMEONE
• THEY KNOW IT
• THEY DON’T KNOW IT
Reality
I’m in a Dead Specialty
• Lookalike products from
company S and Z and D
and W and I and pretty
much everyone else
• Large companies have
a stranglehold on the
sales channel
• “New Technology” is priced at
an unaffordable premium
• Innovation is DEAD
An orthopedic
surgeon’s
perspective of
DISRUPTION
Orthopedic Change
You’re going to
replace me
with a robot!!!
I am Proud
I am Strong
I am Surgeon!!!
Now Dr. Bueller,
Your Press Ganey
scores are in the 50th
Percentile. Your
infection, complication
and readmission rates
are worse than your
peers. We have
no choice but to
let you go.
Today.
CH CH Changes
• >50% of our time is in documentation
• We are pushed to be more efficient in an ever
increasing regulated environment
• We are instructed (beaten up) to
be cost conscious
• We have our “results” publicly disclosed
MACRA
EHR ACO ACA
Compliance
Approvals
Workers Comp
PQRS
Logins
PROM
Opioids
Online Reviews
Pain Management
Social Media
And You Want Me to Do WHAT for you????
MOC
What’s a
surgeon to do?
Stop Whining and
Solve the Problem
Innovation: Where
does this occur
• Academic Institutions - Haphazard, “Gatorade Syndrome,”
Very little ROI for NIH, academic wanderings. “We are
really smart, of course people will buy it!”
• Lone Wolf or “Garage” - No or Limited Resources and
limited knowledge of the process; sales are a mystery
• Small Company - Just trying to survive “Death Valley”
and worrying about the next financing
• Large Company - Top Heavy Bureaucracy, looking for
acquisitions. No venture or co-investing like Pharma, so
this creates even less likelihood for new products/services
Whose Problem (Pain)
is it, Anyway?
• Everyone
• Surgeon
• Surgical Staff
• OR
• Tech Committee
• Hospital
• Insurer
• Patient
• Employer
• Patient’s family
Pain
• You will take
• You will give
Change
• Incremental
• Evolutionary
• Revolutionary
• Disruptive
A Recent Innovation?
• Single packaging of implants
• Surgery Center/Hospital
has less to sterilize
• My reality - Ankle Fracture is
typically a plate and 8 screws
• The time from single box
opening to the start of
implantation is 3 minutes
• 24 minutes of OR time
is $700-$1,500
• My last ankle fracture, total
time was 21 minutes
Obsolesce
• You will be
causing
someone’s
• Yours
• Competitor
• Acquirer
Real Innovation
• Improves lives
• Effortless
• May be a stepping stone
to more positive changes
• Seems easy
• Habits; it’s all about habits, wants and then needs
Fuzzy Puzzle
Pieces
Parts are
coming
together
Renaissance
Florence
was the true
innovation
center
The long and winding road to innovation
Yes, someone will tell you your baby is ugly
Efficacy
• Does it work as advertised?
• White papers are like toilet
paper - just for flushing
Failure
• Fail fast -
because I can’t
• Don't fail so
often that you
are no longer
credible or your
business
can't exist
Innovations I’ve seen
• Intuitive - not just the robot, but the
sales/marketing strategy
• OrthoHelix
• Anodized implants as a code to size
• P-nut plate - a static or compression staple
• Variable locking mechanism in
the screw, not the plate
Execution
• The best innovation ever will not make
up for sloppy execution and planning.
Innovation Method
• Solve a real problem
• Make somebody(s) better
• Elegant
• Intuitive
• Cost aware
• Not spreadsheet driven or
blind to real objective data
• Prove it
CUSTOMER EXPERIENCE
“Apple Proves That
This Is The Single
Greatest Source Of
Innovation”
Now go out and make
someone better
Balancing Implant Innovation and Price - OMTEC 2017

Balancing Implant Innovation and Price - OMTEC 2017

  • 2.
  • 3.
  • 4.
    “Apple Proves ThatThis Is The Single Greatest Source Of Innovation” And everyone leans forward to listen
  • 5.
    Lessons Bad code isreally bad in healthcare Underestimating the complexity of healthcare should be left to the politicians
  • 6.
    MY VANTAGE POINTS •PRACTICING ORTHOPEDIC SURGEON • SURGICAL SPECIALTY HOSPITAL OWNERSHIP - BILLING COMPANY, PT, DME, MRI • ACADEMIC - TEACHING, PUBLICATIONS AND PRESENTATIONS • FOUNDER OF MULTIPLE MEDICAL-RELATED COMPANIES WITH ACQUISITION • MANY PATENTS - ISSUED AND PENDING • KNOWLEDGE OF STRATEGY, MARGINS, QUALITY, REGULATORY, LOGISTICS, SALES MANAGEMENT, ETC • ADVISOR TO VENTURE FIRMS ON DILIGENCE
  • 7.
    HEALTHCARE - DEFINITION ANYTHINGTHAT HAS TO DO WITH INDIVIDUAL/GROUP WELL BEING
  • 8.
    Innovation - Definition theaction or process of innovating. synonyms: change · alteration · revolution · upheaval · transformation · metamorphosis · breakthrough · new measures · new methods · modernization · novelty · newness · creativity
  • 9.
  • 10.
    WHY IS THEREINNOVATION? • BECAUSE SOMETHING ISN’T WORKING FOR SOMEONE • THEY KNOW IT • THEY DON’T KNOW IT
  • 11.
  • 12.
    I’m in aDead Specialty • Lookalike products from company S and Z and D and W and I and pretty much everyone else • Large companies have a stranglehold on the sales channel • “New Technology” is priced at an unaffordable premium • Innovation is DEAD
  • 13.
  • 14.
  • 15.
    You’re going to replaceme with a robot!!! I am Proud I am Strong I am Surgeon!!!
  • 16.
    Now Dr. Bueller, YourPress Ganey scores are in the 50th Percentile. Your infection, complication and readmission rates are worse than your peers. We have no choice but to let you go. Today.
  • 17.
    CH CH Changes •>50% of our time is in documentation • We are pushed to be more efficient in an ever increasing regulated environment • We are instructed (beaten up) to be cost conscious • We have our “results” publicly disclosed
  • 18.
    MACRA EHR ACO ACA Compliance Approvals WorkersComp PQRS Logins PROM Opioids Online Reviews Pain Management Social Media And You Want Me to Do WHAT for you???? MOC
  • 19.
  • 20.
  • 21.
    Innovation: Where does thisoccur • Academic Institutions - Haphazard, “Gatorade Syndrome,” Very little ROI for NIH, academic wanderings. “We are really smart, of course people will buy it!” • Lone Wolf or “Garage” - No or Limited Resources and limited knowledge of the process; sales are a mystery • Small Company - Just trying to survive “Death Valley” and worrying about the next financing • Large Company - Top Heavy Bureaucracy, looking for acquisitions. No venture or co-investing like Pharma, so this creates even less likelihood for new products/services
  • 22.
    Whose Problem (Pain) isit, Anyway? • Everyone • Surgeon • Surgical Staff • OR • Tech Committee • Hospital • Insurer • Patient • Employer • Patient’s family
  • 23.
    Pain • You willtake • You will give
  • 24.
    Change • Incremental • Evolutionary •Revolutionary • Disruptive
  • 25.
    A Recent Innovation? •Single packaging of implants • Surgery Center/Hospital has less to sterilize • My reality - Ankle Fracture is typically a plate and 8 screws • The time from single box opening to the start of implantation is 3 minutes • 24 minutes of OR time is $700-$1,500 • My last ankle fracture, total time was 21 minutes
  • 26.
    Obsolesce • You willbe causing someone’s • Yours • Competitor • Acquirer
  • 27.
    Real Innovation • Improveslives • Effortless • May be a stepping stone to more positive changes • Seems easy • Habits; it’s all about habits, wants and then needs
  • 28.
    Fuzzy Puzzle Pieces Parts are coming together Renaissance Florence wasthe true innovation center The long and winding road to innovation
  • 29.
    Yes, someone willtell you your baby is ugly
  • 30.
    Efficacy • Does itwork as advertised? • White papers are like toilet paper - just for flushing
  • 31.
    Failure • Fail fast- because I can’t • Don't fail so often that you are no longer credible or your business can't exist
  • 32.
    Innovations I’ve seen •Intuitive - not just the robot, but the sales/marketing strategy • OrthoHelix • Anodized implants as a code to size • P-nut plate - a static or compression staple • Variable locking mechanism in the screw, not the plate
  • 33.
    Execution • The bestinnovation ever will not make up for sloppy execution and planning.
  • 34.
    Innovation Method • Solvea real problem • Make somebody(s) better • Elegant • Intuitive • Cost aware • Not spreadsheet driven or blind to real objective data • Prove it
  • 35.
    CUSTOMER EXPERIENCE “Apple ProvesThat This Is The Single Greatest Source Of Innovation”
  • 36.
    Now go outand make someone better