This presentation focuses on the surgeon entrepreneur perspective on how to balance design discipline before creativity and provides recommendations on what surgeons seek in new devices.

2. OMTEC 2017
David Kay, M.D.

3. Realities of Healthcare
Innovation

4. “Apple Proves That This Is The
Single Greatest Source Of
Innovation”
And everyone leans forward to listen

5. Lessons
Bad code is really 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
ANYTHING THAT HAS TO DO
WITH INDIVIDUAL/GROUP WELL BEING

8. Innovation - Definition
the action or process of innovating.
synonyms: change · alteration ·
revolution · upheaval · transformation ·
metamorphosis · breakthrough · new
measures · new methods ·
modernization · novelty · newness ·
creativity

9. INNOVATION -
Experts

10. WHY IS THERE INNOVATION?
• BECAUSE SOMETHING ISN’T
WORKING FOR SOMEONE
• THEY KNOW IT
• THEY DON’T KNOW IT

11. Reality

12. 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

13. An orthopedic
surgeon’s
perspective of
DISRUPTION

14. Orthopedic Change

15. You’re going to
replace me
with a robot!!!
I am Proud
I am Strong
I am Surgeon!!!

16. 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.

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
Workers Comp
PQRS
Logins
PROM
Opioids
Online Reviews
Pain Management
Social Media
And You Want Me to Do WHAT for you????
MOC

19. What’s a
surgeon to do?

20. Stop Whining and
Solve the Problem

21. 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

22. Whose Problem (Pain)
is it, Anyway?
• Everyone
• Surgeon
• Surgical Staff
• OR
• Tech Committee
• Hospital
• Insurer
• Patient
• Employer
• Patient’s family

23. Pain
• You will take
• 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 will be
causing
someone’s
• Yours
• Competitor
• Acquirer

27. 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

28. Fuzzy Puzzle
Pieces
Parts are
coming
together
Renaissance
Florence
was the true
innovation
center
The long and winding road to innovation

29. Yes, someone will tell you your baby is ugly

30. Efficacy
• Does it work 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 best innovation ever will not make
up for sloppy execution and planning.

34. 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

35. CUSTOMER EXPERIENCE
“Apple Proves That
This Is The Single
Greatest Source Of
Innovation”

36. Now go out and make
someone better