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Disruptive versus incremental innovation in healthcare …

Disruptive versus incremental innovation in healthcare …. Andy Goldberg MD FRCS(Tr&Orth) Consultant Orthopaedic Surgeon Royal National Orthopaedic Hospital NHS Trust Deputy Director R&D UCL Institute of Orthopaedics & Musculoskeletal Science. twitter/medicalfutures. ?Better?.

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Disruptive versus incremental innovation in healthcare …

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  1. Disruptive versus incremental innovation in healthcare… Andy Goldberg MD FRCS(Tr&Orth) Consultant Orthopaedic Surgeon Royal National Orthopaedic Hospital NHS Trust Deputy Director R&D UCL Institute of Orthopaedics & Musculoskeletal Science twitter/medicalfutures

  2. ?Better?

  3. Market cap $340Bn Largest company in the world T/o - $65Bn, $14Bn Profits Making it 111th company in size

  4. Market cap $340Bn Largest company in the world T/o - $65Bn, $14Bn Profits Making it 111th company in size T/o $350Bn with $30Bn Profits

  5. Disruptive Technology

  6. Adoption of Innovation Everett Rogers, Professor of Rural Sociology, Iowa (Rogers, Everett M. (1962) Diffusion of Innovations)

  7. Adoption of Innovation Everett Rogers, Professor of Rural Sociology, Iowa (Rogers, Everett M. (1962) Diffusion of Innovations)

  8. Adoption of Innovation JVC VHS Sony’s BetaCam Everett Rogers, Professor of Rural Sociology, Iowa (Rogers, Everett M. (1962) Diffusion of Innovations)

  9. Adopter’s willingness to participate • Awareness • Interest • Evaluation (evidence base) • Tendency to risk

  10. Adopter’s willingness to participate • Awareness • Interest • Evaluation (evidence base) • Tendency to risk

  11. Uncemented Hips • Meyer • Burutaran • L.S Barouk

  12. Uncemented Hips

  13. Uncemented Hips

  14. Uncemented Hips

  15. Stepwise Introduction of Technology* • Preclinical Testing • First In Man • Clinical Trials • Post Market Surveillance * Malchau 1995 (modified)

  16. Stepwise Introduction of Technology* • Preclinical Testing • First In Man • Clinical Trials • Post Market Surveillance – FDA & MHRA * Malchau 1995 (modified)

  17. Are we joined up? • FDA/MHRA • Clinical Groups • NICE • Insurers/Commissioners • Industry * Malchau 1995 (modified)

  18. New Proposal • Industry has commercial pressures • NHS funds research (circa £1Bn) • Quid Pro Quo * Malchau 1995 (modified)

  19. New Proposal • New 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

  20. Q&A Session andy@medicalfutures.co.uk

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