Leveraging CMU science and engineering to reinvent reinvention.
There certainly is no shortage of effort being focused on healthcare technologies in the United States. Together, government and the private sector invest $120 billion annually1 on healthcare research and development. Health-related startups attract a substantial portion of venture capital dollars, second only to Internet companies.2 Yet, too often, healthcare R&D can be a disjointed and protracted process. Even the best ideas can run into insurmountable barriers in navigating through proof of concept, clinical trials, regulatory approvals, acceptance by provid-ers and reimbursement by government and commercial payers.
We believe the time is right for a fresh approach to healthcare innovation, one that streamlines the process itself, and, at the end of the day, delivers more value by targeting rapid adoption and widespread benefits. The need for such innovation is urgent. Today, our nation spends far more on healthcare than any other country—per capita and as a percentage of GDP—without proportion-ate health benefits. The United States ranks last among eleven developed nations in healthcare efficiency, equity and outcomes, and scores low on quality of service.3 And despite a recent slowing in the rate of escalation, U.S. healthcare costs are on an unsustainable trajectory, reaching $10,000 per person in 2015.4
At DHTI, we see a wealth of opportunities for bending this trajectory toward faster, smaller, less invasive, more effective solutions. Com-putational and personalized technologies, for example, are dramatically transforming one industry after the next, driving down costs while increasing transparency, accessibility and choice for consumers. Such technologies have made few inroads in the healthcare domain to date, yet their potential impacts can be enormous.
If the desired end is simpler, more affordable and more accessible healthcare solutions, how can we begin with that end in mind? At DHTI, we see two prerequisites:
• First, creating strong partnerships across payers, providers and innovators. Making smart solutions widely accessible hinges on acceptance by payers and providers. Through DHTI, payers and providers are integral partners from the outset, iden-tifying high-priority opportunities that can have far-reaching impacts on cost reduction and quality improvement. In the hands of world-class computer scientists, payer data is translated into insights on market needs. The result? Exciting solutions are introduced to a ready-and-waiting marketplace.
• Second, welcoming—even insisting on—fresh perspectives. Disruption generally does not come from expected sources. Indeed, we believe CMU’s lack of a med-ical school is advantageous. DHTI fosters partnerships between clinicians and diverse CMU disciplines in a wide range of basic and applied sciences, as well as information science, behavioral econom-ics, engineering, entrepreneurship and human-centered design. We find that a mix of perspectives dramatically expands the variety and originality of promising solutions brought to the table.
Our aim is to spur successful—and some-times surprising—solutions to pressing problems in healthcare delivery.
We unite innovators, payer and provider to tackle
The foundation of DHTI is a novel partnership between a payer, a provider and innovators. This partnership is bolstered by agreements to enable seamless collaboration, including the sharing of anonymized payer data that provides deep insights into promising areas of opportunity for enhancing wellness while containing costs.
We begin identifying areas of research focus by convening a series of structured discussions and brainstorming sessions with CMU senior Principal Investigators, clini-cians, payers, Allegheny Health Network and Highmark Health leadership, deans, executive leadership and national thought leaders, including advocacy groups, phil-anthropic foundations and benchmarked organizations. These discussions are orga-nized as interdisciplinary Strategic Planning for Disruptive Innovation (SPARK) retreats. Retreats utilize horizon-mapping techniques to determine how technology can increase the simplicity, affordability and accessibility of healthcare delivery; qualify potential costs of collaborative R&D; identify poten-tial barriers likely to inhibit innovation and develop strategies to overcome them; and quantify how technology implementation could yield a return on investment for strategic clinical and industry partners.
The SPARK retreat process is a powerful platform for targeting areas of strategic importance, initiating multi-disciplinary collaborations and gaining consensus on priorities for programs, funding and partner-ships. Retreat outcomes are used to inform the annual DHTI Request for Proposals (RFP) process and to shape new projects for improved delivery of care and decreased costs. The process also provides ideal forums for networking of diverse communities around common topics, catalyzing relation-ships among innovators and clinicians and setting the stage for effective technology development and clinical trials.
Since 2012, SPARK retreats have resulted in the identification of six areas of focus for DHTI research:
• Medical Diagnostics. Projects in this area pursue viable detection devices that integrate solutions to infection sensing, sensor immobilization, signal transduc-tion and processing, power, packaging and communication. Overcoming barriers to acceptance by health providers is a driving concern.
• Transforming Care Delivery. Projects address behavioral medicine and thera-pies related to child trauma; tools to help patients, families and clinicians plan, com-municate and enforce choices on end-of-life care; and financial and nonfinancial incentives that a health system may use to improve care efficiency, affordability and accessibility.
• Chronic Disease Management. This area encompasses infection prevention and treatment, with a focus on hospital-ac-quired infections; approaches to chronic wound healing that can reduce treatment costs while improving outcomes; and pain management approaches that avoid or mitigate the addictive potential of the most effective current therapies.
• Computational Healthcare. Projects in this area apply data mining and machine learning; guide patients as they tackle healthcare challenges; develop expert systems responding to personalized patient profiles; support data collection and analysis to inform personalized care decisions; and utilize tools that simulate real patients and clinical environments.
• Re-Engineering the Healthcare System. This area of focus encourages develop-ment of new care delivery models. For example, a current DHTI project is using an algorithmic approach to revisit the ideal structure of a cross-functional care delivery team compensated in a manner that drives higher quality.
• Medical Robotics. Projects in this area address orthopedic robotics, including the incorporation of new imaging technolo-gies and mechanical devices that reduce risks of collateral damage to surrounding areas; and automated decision support using data analytics or automation to decrease costs and increase safety and quality control when dispensing and monitoring drugs.
1. H. Moses, D. Matheson, et. al. “The Anatomy of Medical Research.” JAMA 313:2. 2015.
2. National Venture Capital Association. Yearbook 2015. March 2015.
3. K. Davis, K. Stremikis, C. Schoen, and D. Squires. Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System
Compares Internationally. The Commonwealth Fund. June 2014.
4. Centers for Medicare