Shifting your perspective – and thinking in a ‘new box’ – can transform your company and create new opportunities for the future. Models, concepts and frameworks are – to use another phrase – mental boxes within which we comprehend the real world. And ever since the 1960s, we have been taught to be creative by “thinking outside the box.” The trouble is this: once you have mentally stepped outside the box, what happens next? The space outside the...

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Shifting your perspective – and thinking in a ‘new box’ – can transform your company and create new opportunities for the future. Models, concepts and frameworks are – to use another phrase – mental boxes within which we comprehend the real world. And ever since the 1960s, we have been taught to be creative by “thinking outside the box.” The trouble is this: once you have mentally stepped outside the box, what happens next? The space outside the box is very expansive – infinitely so – and there can be no guarantee that you will find a solution to your problem. So the answer is that you need to find a new box. And you must consciously build or choose that box yourself; if you do not, an unconscious process will do it for you. The way we think means that we cannot be creative in a constructive way without inventing models or boxes. Ideally, you need to develop a number of new boxes – new models, new scenarios, new ways of approaching a problem – to structure your thinking. The challenge – and the real art of creativity – is to know how to build those new boxes and, in the process, provide the framework for fresh imaginative effort. Let’s take an example from outside the medtech industry before considering how we might apply this approach to meet the healthcare needs of the future. Half a century ago, Bic, a French stationery company, brought to market the idea of making low-cost pens.Some creative brainstorming produced a series of variations on the theme: two colors, three colors, gold trim, advertising logos, erasers, and so forth. But who would have imaged Bic making a razor? Or a lighter? Bic could come up with those ideas only by adopting a radical change...
This blog is part 7 of a series on the MEAT value-based procurement project, an initiative that advocates towards a shift from price-based procurement towards value-based procurement. It does so by defining a Most Economically Advantageous Tendering (MEAT) framework that includes the value of medical technologies, services and solutions in procurement processes across Europe. Read part 1 , part 2 , part 3 , part 4 , part 5 and part 6 . Who looks after human health – surgeon or public procurement official? The answer should be: both. The concept of Value Based Procurement helps us to explore the link between purchasing decisions and health. Implementation of the new Public Procurement Directive spurred discussion in the healthcare sector on how to define the best value of purchasing goods and services. While we are moving away from price-only criteria and there is some more emphasis on the overall cost of care delivery, we are still far away from obtaining most economically advantageous outcomes. Besides additional direct cost impacts driven by energy-use, cost of spare parts or disposal, one needs to quantify and take into account the savings derived from reduced patient’s length of stay, rate of readmissions, etc. This however does not capture all cost the society bears. What is also explicitly addressed by the new Public Procurement Directive, but often overlooked in these debates, are the environmental and social aspects of delivering patient care. Meanwhile, Sustainability issues such as clean air and water, and fair working conditions are fundamental contributors to population’s health and are valued by our society. This approach should be not only reflected in the delivery of care but also in purchasing practices. Such vision of health positions sustainability as an important policy objective and challenges a narrow scope of healthcare focusing solely on management of...
During the past few years, several trends have emerged that are reshaping how health care is delivered. Health systems continue to consolidate. Risk sharing and price sensitivity are more commonplace than ever. Payors are no longer rewarding incremental innovation. The cumulative effect of these trends is a willingness by healthcare providers to use ‘good enough’ products with a reluctance to use products that provide only an incremental benefit. However, as much as things are changing, one thing remains critically important: health care systems are still looking at the healthcare industry to develop truly meaningful innovation that positively affects patient’s lives. Yes, reducing costs is critical, but delivering better outcomes and better patient experiences have risen to the top of demands from health systems globally. Our focus should be on transforming clinical care through meaningful, differentiated innovation. It is important to have healthy debates about the capabilities and opportunities that exist within different approaches to innovation, especially the differences between outcomes innovation, when a patient’s prognosis is improved and process innovation, where there is a change in procedure performance or cost, but no meaningful impact on the patient. This distinction is critical, because if we are to truly deliver transformational innovation that positively affects the lives of patients, we must have an unrelenting focus on outcomes not process. To redefine innovation we need to focus on disease states and the entire continuum of care. We need to source innovation wherever it is, within our company or externally. And, as we are innovating, we must consider product attributes that deliver the evidence and value for payors that ultimately leads to access for patients. Within Johnson & Johnson, we have adopted a broad-based approach to innovation to allow us to deliver the promise of products that are truly transformational. The key is to...
Since the beginning, patient empowerment has been a central pillar of the European Patients’ Forum (EPF)’s vision and mission. Our aim is to promote patient-centred health systems involving patients in the decision-making and management of their condition. Following a consultation with our members, we decided to strengthen this commitment by setting up a one-year campaign dedicated to patient empowerment. The Patient Empowerment Campaign saw the light in May 2015 aiming to take the European discussion on this topic to the next level, towards concrete political actions. The campaign succeeded in promoting understanding of the concept, in raising awareness about the positive impact of patient empowerment both on patients’ lives and on healthcare systems and, above all, in calling up those crucial stakeholders that can actually make a difference. In this regard, I was delighted to see all the support we received from partners and policy makers. On one hand, national and European organisations embraced our campaign and helped us to spread the message on social media, in the European health arena and also at national level with events across Europe. On the other hand, Members of the European Parliament and representatives of the European Commission showed their commitment and willingness to work with us to move the topic forward. This commitment was particularly apparent during the closing event of the campaign last June in the European Parliament. In the form of a roundtable, the event was a great point of discussion where panellists and participants debated different approaches of empowerment – such as access to quality healthcare for all, health literacy and patient education – and reached a clear conclusion: we need empowered patients to build a better and more sustainable healthcare system. The campaign is now officially closed, but our work does not end here. We have now two...
I'm greatly looking forward to the European MedTech Forum meeting in Brussels in December, where I’ll be talking at the plenary about payers and hospitals aligning expectations and sharing values. I'll also be taking part in a panel session on personalised and precision technologies. NICE is ideally placed to help the medical technology and diagnostics industries to meet increasingly challenging expectations in resource-constrained health systems. Through our Medical Technologies Evaluation and Diagnostics Assessment Programmes we produce evidence-based guidance and advice on innovative medical and diagnostic technologies for the National Health Service (NHS) in England, recommending those that are clinically and cost-effective. Payers are often most uncertain about the value of a new technology at the point where an adoption decision is needed for the whole health system. NICE is able to help in these situations by targeting further evidence development on the specific uncertainties remaining about the use of the product once we have done our evaluation. We work with academic evidence assessors to produce a protocol which the company can then use to target their research on those uncertain outcomes, enabling us to update our guidance at a future point. Of course, we would prefer companies to undergo a NICE evaluation with the correct evidence already in place, so we also offer a Scientific Advice service to companies as they plan their trials. The cost of developing evidence is a major concern to companies facing short patent lives, “fast-followers” and frequent device iterations. NICE is involved in a work stream of EUnetHTA Joint Action 3 that seeks to create a quality tool for registers being used to collect health outcome data. The aim is to give guidance to register developers (including companies) and those using the data for HTA, a common set of standards so that companies don’t waste...
What is your day-to-day work like? How do you help improve or save people's lives through your work? I work in Ljubljana University Medical Centre, Ljubljana, Slovenia and I’m head of the Paediatric Trauma Unit. I studied and received my medicine degree in the same city, in Ljubljana University. I’ve specialised in orthopaedic trauma for 16 years. Caring for an injured child requires special knowledge, precise management and great attention-to-detail. An injured child has unique needs and a multidisciplinary approach is needed to deal with the emotional as well as the medical needs of the child. But the majority of my work involves adult trauma patients and my focus in particular is on elbow, hand and wrist trauma and reconstructions. It’s a busy, challenging role with complicated procedures, especially when it’s a poly-trauma patient with severe and multiple injuries. Every injury creates a different amount of stress: physical and psychological. If there is a severe injury to a part of the body or to multiple parts, the patient’s health status is not the same as it was before. My job as a trauma surgeon is to improve and to regenerate the function of the injured part of the body as close as possible to what it was previously. So with different treatment modalities I strive to improve the patients live. This can be done diversely : with non-operative or a surgical treatment, depending on the type of injury. What do you think are the challenges facing the healthcare system and your profession in particular? The line of work we carry out is very complex and demanding. Having a team that can take into account the specificities of the injured patient is key, as well as supporting the family who are facing considerable emotional turmoil and worry. A high-level of education...