care innovation. In his new book, The Patient Will
See You Now, he describes medicine’s “Gutenberg
moment”: just as the printing press liberated
knowledge from the control of an elite class; now,
digital health technology is poised to do the same
for medicine, “democratizing” it in ways that were
unimaginable until now. Specifically, smartphones
will perform blood tests, medical scans, and even
do parts of the physical examination.
Need to rethink research? Thinking big requires
that you imagine massive, open, online medicine,
where diagnostics are done by comparisons of medical profiles (yes, computer-generated diagnoses and
recommendations), enabling real-time, real-world
research on massive populations. Dr. Topol makes
it clear that the path forward will be complicated:
the medical establishment will resist these changes,
and digitized medicine inevitably raises serious issues surrounding privacy. Nevertheless, the result—
techno optimist that he is—will be better, cheaper,
and more humane health care.
just disappear. According to John A. Rogers, PhD,
a professor of materials science and engineering
at the University of Illinois at Urbana-Champaign,
“This is a new class of electronic biomedical
implants [that] have potential across a range of
clinical practices, where therapeutic or monitoring devices are implanted or ingested, perform a
sophisticated function, and then resorb harmlessly
into the body after their function is no longer
necessary.”1
How do we get from ideas to innovations like
this? Daniel Kraft, MD, Faculty Chair for Medicine
at Singularity University and Founding Executive
Director of the conference. “Particularly in the
health care space [...] technology is just the enabler.
It’s really an integration of people, technologies,
ideas, synergies, workshops, demos, where we can
see not only what’s on the cutting edge today but
where things will be in the very near future.”
Not content to just present exponential technologies, the conference also addressed how to
“There is a shared interest among
innovators to find the settings where
emergent technologies [in medical
practice] can be given a fair and
- Dave Chase
thorough review.”
For example, at the 2013 Exponential Medicine meeting, Dr. Topol introduced attendees to
the idea of continual blood surveillance using an
injectable nanosensor that can detect a genomic
signal from a cell type that starts circulating in
the blood during the early minutes of a myocardial infarction. That signal can then be relayed
to a smartphone and the patient will receive a
“Heart Attack Ringtone.” (While such a ‘call’ from
your heart might be a touch stress-inducing itself,
maybe it can convince people that what they’re
feeling is not last night’s pepperoni pizza back for
an encore, encouraging them to dial 911.) Similar
technologies could be used to monitor autoantibodies to the Islet cells in the pancreas in children
with high genomic risk for developing type 1 diabetes or plasma-detected cancer markers, said Dr.
Topol. As he puts it: There are about 400 sensors
in the average car today; why shouldn’t we have
any in our bodies?
Another example: On Jan. 18, 2015, in the
journal Nature, investigators reported on the development of tiny brain implants that do a crucial
monitoring job after brain injury or surgery, then
28 CardioSource WorldNews
introduce and scale new technologies properly so
they are accepted and efficacious. “Without fertile ground, exponential technologies will die on
the vine,” wrote Forbes contributor Dave Chase, a
speaker, entrepreneur, and investor who is considered a top influencer in shaping digital health today.
“Historically it has taken 17 years for medical
research to flow into regular medical practice,” said
Chase. Allowing some of the exponential technologies out there—which he terms health care “bunker
busters”—to get bogged down unduly (assuming
the science has been proven) would be bad. “Consequently, there is a shared interest among innovators
to find the settings where emergent technologies
can be given a fair and thorough review.”
Why “bunker busters?” Well, because current
industries, let’s call them the “incumbents,” have
built a $3 trillion fortress “to protect their turf,”
said Chase, suggesting that this “under-performing
healthcare bunker” is ripe for busting.
Minting Clinician Innovators
Academic medicine with its traditional tripartite
mission of clinical care, biomedical research, and
education has and will always generate much of
the basic research that provides the foundation for
healthcare innovation. However, not all academic
medical centers are good trainers or supporters of
the new breed of physicians who have been dubbed
‘clinician innovators.’
These newcomers still seek the usual board certifications and want to treat patients and maybe
have an academic appointment. The difference
lies in their background: some of these doctorsin-training have pre-medical school experience
presenting to investors, filing patents, prototyping, or even doing an IPO or two. This innovation
generation has a ‘virtual’ advantage, too, in that
they come from a “digitally intuitive” generation,
unlike their teachers. They arrive on the scene at
a propitious time, as tight budgets and the Affordable Care Act of 2010 have compelled academic
medical institutions to make their care delivery
more efficient and cost effective, an area where
high-tech innovations may be just what the doctor’s boss ordered.
In a Dec. 2015 “presidentially commissioned”
Special Report in the Journal of the American Heart
Association, Maulik Majmudar, MD, and colleagues (including the current CEO of the AHA,
Nancy Brown, BS) discussed how to foster innovation in academia and the new designation of
“clinician innovator.”2 Dr. Majmudar is the Associate Director of the Healthcare Transformation Lab
at Massachusetts General Hospital.
Dr. Majmudar and colleagues noted that training programs need to invest time and resources
to this effort and offer didactic lectures, including lectures by innovators with a proven track
record, covering a non-traditional range of topics
“as diverse as healthcare economics, health information technology, health policy, quality and
outcomes, lean startup methodology, human-centered design, big data, medical writing, intellectual property, innovation and entrepreneurship,
as well as leadership and management.” As if that
wasn’t enough, these programs also need “collaborative mentorship, action learning electives,
and assignment of individual projects that are to
be complete and presented by the completion of
professional training.”
So where are such programs to be found? The
Stanford BioDesign program is a leader in this
effort, now in its 15th year of training fellows and
with dozens of successful startups to its credit.
More recently, the Healthcare Transformation
Lab at Massachusetts General Hospital launched
Co.Create, a program that seeks to “accelerate the
translation of early-stage ideas into scalable and
sustainable healthcare ventures.” Dr. Majmudar,
the first author on the JAHA report, is the Associate Director of the Healthcare Transformation Lab.
The spark of innovation can be found igniting in
various other settings around the country—and
world—as well.
While acknowledging the need for academia to
February 2016