Category Archives for "Disruptive Innovation"

Dec 27

Spine & Health Info Platter (27 Dec ’17)

By Kanwal Sood | Artificial Intelligence , Big Data in Healthcare , Blockchain , Disruptive Innovation , Internet of Things , Spine Care , Value-Based Healthcare , Wearable Tech

In this week’s platter, we look at smart bandages, physicians who are prescribing mobile apps to their patients, the power of a humble spreadsheet, AI and 10 healthcare IT predictions for 2018. Sign up for our newsletter on the left. Enjoy:

Five major shifts in the transformation of healthcare (MaRS)

Healthcare in the developed world is undergoing a transformation. This infographic does a great job of capturing at least 5 of the major shifts.

Smart bandages for monitoring and treatment of chronic wounds

Researchers from 3 academic institutions in the USA have designed a smart bandage that could eventually heal chronic wounds or battlefield injuries with every fiber of its being. The bandage – the first of its kind that is capable of dose-dependent drug release – consists of electrically conductive fibers coated in a gel that can be individually loaded with infection-fighting antibiotics, tissue-regenerating growth factors, painkillers or other medications. A microcontroller no larger than a postage stamp, which could be triggered by a smartphone or other wireless device, sends small amounts of voltage through a chosen fiber. That voltage heats the fiber and its hydrogel, releasing whatever cargo it contains.

Elsewhere, researchers in Saudi Arabia have developed a smart bandage for real-time wirelesss monitoring of chronic wounds. This technology solves the problem of wound monitoring by offering a low-cost wearable smart bandage that detects early signs of wound infection such as bleeding and pH variations and can measure external pressure on the wound. This simple bandage strip can remotely send wound progression data and issue early warnings to patients, as well as remote medical staff, regarding the need to change the dressing. See description here

Dear Patient, please don’t forget to download your prescription (YouTube)

Someone once said that if we were told that the brain were a mobile app, we would surely us it more! That just goes to demonstrate the ubiquity of mobile computing in our age. This short clip introduces a digital medicine-centric care delivery system that enables physicians to digitally prescribe mobile health apps to patients.
But as with everything new, some of these innovations are treated with a dose of healthy skepticism as they lack evidence to suggest that they work, or more gravely, that they don’t cause harm. Another big challenge will be to ensure that the tech projects are compatible with each other (…hear the cry for Open Standards…)
Pharma and apps – never would have imagined that…

How do we heal medicine? (TEDTalk)

Our medical systems are broken. Doctors are capable of extraordinary (and expensive) treatments, but they are losing their core focus: actually treating people. Doctor and writer Atul Gawade explores how doctors can dramatically improve their practice using approaches as simple as … a checklist – or coaching
Gawande suggests we take a step back and look at new ways to do medicine — with fewer cowboys and more pit crews.

Five AI breakthroughs that could change the face of science (Imperial College)

Barely a week has gone by in 2017 without warnings in the media about how Artificial intelligence (AI) and robotics is threatening to make all human workers redundant.
AI techniques, such as machine learning, represent a complete step-change in ability.
We take a look at five stories this year where scientists used AI in completely new ways

10 Health IT predictions for 2018: Al, blockchain, robotics and a $100 million class-action suit (Healthcare IT News)

And finally, we let’s take a peek into 2018 and see which emerging technologies will start to gain some firmer footing in the year ahead.

Happy new year everybody!

Dec 19

Spine & Health Info Platter (19 Dec ’17)

By Kanwal Sood | Artificial Intelligence , Big Data in Healthcare , Disruptive Innovation , Spine Care , Spine Cloud Platter , Wearable Tech

This week, we pay attention to the use and expanding potential of virtual reality in healthcare; how trust is the real variable for healthcare system improvement; how design thinking can be leveraged to offer solutions to some problems even in healthcare; and to a minute sweat analyser. Sign up for our newsletter on the left. Enjoy:

Virtual Reality in Medicine: New Opportunities and possibilities

Medical VR is an area with fascinating possibilities. It has not just moved the imagination of science-fiction fans, but also clinical researchers and real life medical practitioners. Although the field is brand new, there are already great examples of VR having a positive effect on patients’ lives and physicians’ work.
Researchers from the University Hospital of Basel’s Department of Biomedical Engineering have now succeeded in taking two-dimensional cross-sections from computer tomography and converting them for use in a virtual environment. For example, doctors can now use the latest generation of virtual reality glasses to interact in a three-dimensional space with a hip bone that requires surgery, zooming in on the bone, viewing it from any desired angle, adjusting the lighting angle, and switching between the 3D view and regular CT images – offering the doctor a very intuitive way to obtain a visual overview and understand what is possible.
Elsewhere, the Washington Post reports how doctors used VR and a 3-D print model to simulate a surgery to separate conjoined infant twins and ultimately save their lives- see here.
The application of VR in healthcare has potential beyond just training simulation and surgical procedures. This article presents how VR can be applied to aid physicians to experience life as their patients, or making hospitalized children feel like they’re at home.

Sensor Pulls Sweat from Skin to Measure Multiple Biomarkers (MedGadget)

Researchers from École polytechnique fédérale de Lausanne (EPFL) and a Swiss company called Xsensio have presented a new sweat sensor capable of detecting a number of useful chemical biomarkers, as well as the sweat’ pH level and temperature of the skin. 10,000 times smaller than the today’s most advanced devices, one will have to simply stretch their minds to understand the potential of this technological development!

How to improve health care using game theory: the Prisoner’s Dilemma

The healthcare industry is facing real challenges and is in need of some real solutions. This dated article looks to game theory to help us understand one of the underlying impediments to healthcare system improvement. In summary, it all comes to trust…

Healthcare designers can use design thinking to improve patient experiences (HBR)

In a world of great technological advances, one is tempted to seek improvement of patient experiences by adopting better technology or by deploying some other clinical solution. Recalling that healthcare is about restoring wholesomeness to the person and not only about attacking a disease, this article describes how non-clinical aspects can be leveraged to improve patient experiences – by employing “design thinking.” A short treatise of design thinking is found here
Feel free to contact the Spinecloud team to discover how design thinking was used in the development of the proprietary Spine Care Pathway.


Dec 11

Spine & Health Info Platter (11 Dec ’17)

By Kanwal Sood | Artificial Intelligence , Disruptive Innovation , Spine Care , Spine Cloud Platter , Value-Based Healthcare , Wearable Tech

This week we look at Sophia: the first robot declared a citizen by the Kingdom of Saudi Arabia; the evolution of training of spine surgeons with the introduction of 3D printed spines; what the CVS-Aetna deal means for delivery of healthcare; Bill George discusses solutions to our most pressing health-care problems; and, finally, the 12 most over-hyped technologies in healthcare. Sign up for our newsletter on the left. Enjoy:

Meet Sophia: The first robot declared a citizen by Saudi Arabia

Saudi Arabia says it has become the first country in the world to grant citizenship to a robot.
The female robot’s name is Sophia, and she is presented as an example of how robot technology and artificial intelligence will make machines more human-like in the future.
Sophia was built by Hong Kong-based Hanson Robotics. The company’s founder, David Hanson, says his goal is to create robots that look and act very much like humans.
Artificial intelligence is advancing. 15 years ago – this was the substance of sci-fi series and today it is fast becoming a reality

‘Lifelike’ 3D printed spine to help train spinal surgeons

Simulations for training in critical situations are apparent in various industries – military, aviation, event management etc.
Thanks to the wonders of 3D printing – simulations have also entered the spine care domain and promises a step change in the performance of trainee surgeons and in the reduction of errors. A project led by Nottingham Trent University aims to give trainee surgeons the “tactic knowledge” of how it feels to partly remove or drill into vertebrae before undertaking procedures on patients. The models – which are created using powder printing technology to help achieve a lifelike porosity of real bone – feature hard outer layers and a softer centre. When dealing with the spine, we all acknowledge that one error can lead to catastrophic, life-changing consequences for a patient, so it’s imperative that surgeons can prepare themselves thoroughly. This research will enable clinicians to experience how performing spinal surgery feels both physically and mentally, but in a safe training environment.

Innovation key to solving America’s health-care problems

In this video, Bill George, former Medtronic Chairman & CEO, Harvard Business School Professor, says innovation can solve many of our most pressing health-care problems by making the delivery system more efficient. He posits that delivery systems will be moving from downstream to upstream (focusing on wellness to prevent people getting sick) and will see it moving out of the hospitals and clinics into pharmacies, and ultimately that self-care will become primary care.

What if an app could replace a pill?

What if an app could replace a pill? That’s the big question behind an emerging trend known as “digital therapeutics.” The idea: software that can improve a person’s health as much as a drug can, but without the same cost and side-effects. We’ve seen how the popular consumer apps such as Headspace and MyFitnessPal, help us do things like meditate or manage our calorie consumption. Well, Digital Therapeutics are an evolution of these types of tools, which focus specifically on the prevention and management of chronic diseases, like diabetes (type 2), hypertension, and others.
The ultimate intention is to keep people off medication and out of the hospital, living healthier and happier for longer.
But is it really without side-effects (ever heard of internet/digital addiction or hypochondria)? Let us know what you in think about this.

The CVS-Aetna Marriage – the signal to migrate to fee-for-value

The CVS’s $69 billion acquisition of Athena made front page headlines in the last week (it is the marriage of the financing and the delivery of healthcare). But what exactly does it mean for the delivery of healthcare? According to this article from the Havard Business review, the ramifications of such a deal for traditional care providers typically dominated by hospitals is going to be big and may happen fast.
Their intent appears to be to create the financial incentive to get upstream of the major cost driver in health care: hospitalization. By focusing physician and ancillary resources on preventing unnecessary hospital care, which drives 70% or more of medical cost, the total cost of care and therefore premium cost can be lowered. This cost and service improvement then differentiates the insurers, pharmacies, and other disruptive newcomers in the market. Traditional care providers must understand where the world of incentives is going and jump to an incentive system that rewards value, not volume (This means moving aggressively away from fee-for service payment fee-for-value).

The Most Over-Hyped Technologies in Healthcare

With all the talk about digital disruption in healthcare, it would be useful to inject some sanity and talk about the most over-hyped technologies in healthcare. I must admit that there is a streak of overambition by the party who thought about 3D printed organs

Dec 08

Multistakeholder recommendations for improving value of spine care: Key themes from a roundtable discussion at the 2015 NASS annual meeting (with William Weeks, MD, PhD, MBA)

By John Ventura | Disruptive Innovation , Primary Spine Provider , Spine Care , Spine Publications , Spine Related Disorders , Value-Based Healthcare

Principal author: Dr William Weeks, MD, PhD, MBA – Professor, The Dartmouth Institute

This article was originally published in the Spine Journal: Spine J. 2016 Jul;16(7):801-4

Authors: William Weeks, MD, PhD, MBA, John M Ventura, DC, DABCO, Brian Justice, DC, Hsu E, Milstein A


BACKGROUND CONTEXT: Back and neck problems are among the most common medical symptoms in the general US population, they generate substantial direct and indirect costs, and there is substantial variation in care provided to treat such conditions.

PURPOSE: To brainstorm methods to improve the value of healthcare services provided to patients with spine-related disorders.

SETTING: The 2015 North American Spine Society Annual Meeting in Chicago where a group of providers, insurers, employers, advocates, and researchers convened to discuss ways to improve the value of healthcare services provided to patients with spine-related disorders.

METHODS: Guided by the Institute of Medicine’s six aims of care (safe, effective, patient-centered, timely, efficient, and equitable care), the group surfaced several evidence-based opportunities for improving value.

RESULTS: The opportunities centered on four themes: the need to develop commonly-defined groupings of spine pain patients to ensure fair comparisons of healthcare value; ways to address current misuse of care providers through improved protocols; the need to avoid patient harms including unnecessary risk exposure, disability labeling, and overuse of opioid drug prescriptions; and the need to establish and use, on a broad scale, methods to learn from actual patient care experiences.

CONCLUSIONS: These themes lend themselves to several obvious long-term interventions – identification and establishment of better-specified treatment guidelines targeting specific groups of patients, integration of primary spine care providers who do not prescribe addictive medications as a first-line treatment, and the establishment of registries. The convergence of accelerating and divergent resource consumption for its treatment, widespread use of new delivery and payment methods designed to improve outcomes and curtail the rise in healthcare costs, and availability of technologies that can facilitate data collection, analysis, and learning provide a rich opportunity to improve the value of healthcare delivery for spine pain.

Dec 05

Spine & Health Info Platter (5 Dec ’17)

By Kanwal Sood | Artificial Intelligence , Big Data in Healthcare , Disruptive Innovation , Low Back Pain , Spine Care , Spine Cloud Platter , Spine Related Disorders , Value-Based Healthcare

This week’s health & spine platter covers AI’s challenges & how it can make you a better doctor, disruption and behavioral economics in healthcare & back medical technology through the ages. Sign up for our newsletter on the left. Enjoy:

Six Challenges To Tackle Before Artificial Intelligence Redesigns Healthcare

“Artificial Intelligence will not replace physicians. Yet, medical professionals who use A.I. will replace those who don’t.” Food for thought

10 Ways Artificial Intelligence Could Make Me a Better Doctor

Many fear that algorithms and artificial intelligence will take the jobs of medical professionals in the future. Instead of replacing doctors, AI could augment them and make them better at their jobs. Without the day-to-day treadmill of administrative and repetitive tasks, the medical community could again turn to its most important task with full attention: healing.

How Disruption Can Finally Revolutionize Healthcare

Unlike other industries, healthcare has been largely resistant to the forces of disruptive innovation. Despite advances in technology, the U.S. healthcare sector keeps getting costlier, and is now by far the world’s most expensive system per capita, about 2X higher than the U.K., Canada, and Australia,
Part I of this article focuses on why disruption has not taken hold in the delivery practices of hospitals and physicians groups. They argue that the profound disconnect between what patients need and what patients get from the system – as typified by the fee-for-value reimbursement system – is what lies at the root of the healthcare crisis.
But all is not lost. Part II of the article focuses in on how disruptive solutions have begun to improve health while lowering costs for significant populations, and concludes with key recommendations to each player in the care value chain.

How Behavioral Economics Can Produce Better Health Care

The Royal Swedish Academy’s award of the 2017 Nobel Prize in Economics to Richard Thaler marks the growing influence of the science of behavioral economics, not only in academia, but in popular culture and industry.
Traditional economics is rooted in the assumption that people make rational, self-interested decisions based on a strict cost/benefit analysis of their options. By contrast, the sub-field of behavioral economics acknowledges that human decision-making departs frequently, significantly and predictably from what would be expected if we acted in purely “rational” ways. This articles depicts how the science of behavioral economics could be used to design choice environments that promote healthy lifestyle decisions. It also presents how a start-up seeks to improve patient adherence to mediation by incentivising healthy habit formation for medical adherence.

The inconvenient truth about behavioral economics in healthcare

In contrast to the article above, this author is more cautious about the immediate benefits of the application of behavorial economics in tackling the colossal problem of medication non-adherence. The author warns against discounting the inconvenient truth that people and their lives are complex, so too are their barriers to healthy behavior are. Hence nonadherence and other unhealthy behaviors may be completely rational. And the assumption that they are not can lead innovators to misdiagnose their cause, thus misjudge potential solutions. This article here shares the same sentiment.
The author presents how the use of “Jobs Theory” (as explained here) can help providers gain a thorough understanding of patients’ circumstances, and hence help eliminating both practical and psychological barriers to healthy behavior in a tough set of circumstances.

The back story – Neck and back medical technology through the ages

And finally, for those who were not around when the Titanic sank – this infographic, courtesy of LDR Spine, covers advancements in cervical spine care from 1500 BCE through today. These advancements include meat stabilization techniques used by the ancient Egyptians (yep, that’s right), medieval era inversion chairs (best be glad that you weren’t there) and present day artificial disc replacements. This is a spine platform after-all, so I had to include something specific to spine.

Nov 08

The Rise of Spine Care Pathways

By admin | Disruptive Innovation , Primary Spine Provider , Spine Care , Spine Pathway , Spine Publications , Spine Related Disorders

David Chapman-Smith stated in a masterly editorial several years ago that “The current development of multidisciplinary spine care pathways will assume a dominant role in years ahead.”

Read Mr Chapman-Smith’s editorial summary of the Jordan Spine Programme, headed up by one of our senior partners, Dr Ian Paskowski.  Dr Paskowski heads up the Beth Israel Deaconess Hospital-Plymouth Spine Care Program – a multi-disciplinary service dedicated to providing top-notch care for patients suffering with spine pain. 

The Rise of Spine Pathways – Editorial by David Chapman-Smith (click here to read more)

Apr 22

Constructive Disruptive Innovation: First Touch and Spine Care

By John Ventura | Cultural Authority , Disruptive Innovation , Spine Care , Spine Related Disorders

Written by John M. Ventura, DC, Spine Care Partners, LLC, and Michael Allgeier, DC, medical director, Mercy Spine and Back Care, Mercy Hospital Chicago, IL | Wednesday, 02 July 2014, originally published in Becker’s Spine Review.

When it comes to new technology, Christensen’s model of disruptive innovation can be fairly well understood.

New markets with added value are created by the introduction of a new business model (not just a new technology), which disrupts the existing market. The transistor radio is a classic example of a disruptive innovation. (1)  However, when we discuss a system built upon process, like healthcare, the notion of defining disruptive innovation becomes more challenging. Perhaps O’Ryan’s description of constructive disruptive innovation becomes more relevant. In this construct the goal is to create a model that is less expensive but more creative, more useful, more impactful while still being scalable. Constructive disruptive innovation combines ‘off the shelf’ technology/ideas with the novel and original to improve the process. (2)

It goes without saying that the field of spine care is replete with variation, waste and misuse. Direct costs for spine care have risen almost exponentially over the past three decades, while indirect costs (those typically associated with lost productivity) have followed suit. (3) In spite of these exorbitant expenditures on spine care, our outcomes as measured by disability are worsening.  Many investigators have identified spine-related disorders as one of the costliest health conditions society faces. The need for change is obvious, but what change and how do we get there?Read more