How to do more with less in healthcare | Jan Denecker | TED Institute



make it happen that was what my manager told me 12 years ago I was going to lead an innovation project to develop a new medical imaging device we actually already had a portfolio of devices that worked really well but our mission was to make it even better whatever it takes so we developed the device we launched it back in 2005 got great feedback from the hospitals who were willing to pay extra for the increase in performance looking back I sometimes ask myself was it worth it was the incremental performance improvement was it worth the increase in cost and complexity if I were to diagnose where we are today in healthcare in the developed world it would be this we have made great progress through innovation but we've also made it very complex and very expensive the US and the European Union together spent over four trillion dollars on health care per year the US alone doubled its healthcare spending per person just over the last 20 years but this doubling of healthcare spending did not translate into a doubling of healthcare improvements for example life expectancy in the u.s. just over those last 20 years increased about 3.3 years as we're facing aging population and an increase in lifestyle diseases the need for healthcare will only increase we won't be able to afford the health care system as we know it today we'll have to find new ways to keep our system affordable to get there we'll have to change our mindset to do more with less and this is actually where we in the developed world can learn a lot from the countries in the developing world due to the resource constraints that they are facing they have adopted this mindset for a long time so how can we get there there are many ways to get there but I'm going to share three that I believe are vital in health care the first one is about looking for alternatives we should look for alternative products and solutions that are not only cheaper but that are as safe and effective as the ones that we have take dr. Magnus he's a surgeon who works for a hospital an advanced teaching hospital in Pune one of the largest cities in India many of his patients cannot afford their surgeries so he's always looking for solutions to save costs and even small cost savings with help one of the instruments that he's using during surgery or scout clips Scout Clips keep skin flaps in place while operating but they're hard to find in India and they're very expensive so he was looking for an alternative that functions in the same way he started using this binder clips sterilized of course there they cost less than 1/10 than a scout clip and what's more is that he found that they were as safe and effective this small change can save about 5% of an average cost of surgery in India now why is it that our scout clip is 10 times as expensive as a simple solution like a binder clip have we over designed them here's another example if we have to treat a skin injury we typically use iodine based products the all medical institute in india actually tested an alternative solution one that even the ancient egyptians were already using in their time honey turns out it's amazing they've actually found that honey is more effective in iodine in healing such injuries here's another alternative that is even cheaper and apparently also very effective maggots personally I prefer the honey option but I mean if if you know that worldwide we're spending about four billion dollars on disinfectants and antiseptics there is opportunity also for potential cost savings here just one more quick example power drills and healthcare I know some hospitals in Uganda are actually using everyday power drills instead of surgical drills for their orthopedic surgeries they're using a cover that seals off the power drill so that it remains sterile throughout the surgery cost $450 compared to thirty thousand dollars for a surgical drill what else can we do to do more with less in health care is about keeping it simple many of our health care products and processes are overly complicated so we have to look for opportunities to simplify take the example of an infant incubator in India around the world each year an estimated 4 million babies die in the first 4 weeks of their life but many of these babies could be saved simply by keeping them warm where the traditional infinite qada cost about ten thousand dollars so many hospitals in India cannot afford to invest in them one of the manufacturers of such an incubator GE Healthcare decided to take a different approach rather than asking their R&D center in the u.s. to take out some whistles and bells to reduce the cost but also the performs there as the Innovation Center in India to completely redesign the device so the local developers in Bangalore India did what they always do they started from scratch looked at the basic requirements and look for simple solutions to make it work for example they replaced a series of sophisticated switches with a simple control panel that is cheaper but also easier to use because that control panel only some color codings graphic warnings are very easy to use they also redesigned the tilting mechanism to make it simpler but also more robust so that it can also operate in challenging environments like a countryside hospital maybe in India in the end they managed to develop a device for $3,000 that is 70% less than the current device today that device is FDA approved and it's sold in over 80 countries around the world including my home country Belgium this is a remarkable example of how a different mindset in innovation in healthcare in a developing country can make a difference all around the world also in the developed world how can we further apply now this mindset of doing more with less the Third Way is about looking right under our noses and I'm talking about technologies and solutions that we're using in other industries in the developed world but that we're not leveraging in healthcare or at least not fully leveraging take this technology that is near and dear to my heart barcodes I have to admit they're not very sexy but they have changed our world since 1974 accepting healthcare for years I've helped to advance the use of barcodes in hospitals in my discussions with hospital managers that have implemented those barcodes it is clear that this technology brings great benefits to their hospitals it increases the efficiency of their supply chain and it's also safer for the patient still today for example 78% of the hospitals in Europe are using patient wristbands without a barcodes here's the irony even if there are barcodes it doesn't mean that we're using them I experienced this firsthand earlier this year I got injured playing my favorite sport soccer so they rushed me to this top-notch hospital close to Brussels and now as I was being admitted to the hospital I received a wristband with a barcode great I thought at least I won't be misidentified and I'll get the right treatment to my surprise none of my caregivers scan the barcode during 3 days I was there what's more is as I was being wheeled to the operating room my nurse hadn't checked my barcode nor my file but she still wanted to reassure me that everything was going to be ok see don't don't worry she said your doctor is a specialist in the hand surgery I was there for foot surgery surgeries on the wrong side actually happened more off than you may think experts estimate that they're about 40 per week in US hospitals alone I wasn't one of them luckily I've met the surgeon the day before so he knew I was there but still the other thing that I noticed with barcodes as I was in the hospital is that none of the medical products were being scanned as I was as I was there imagine this would happen in an airport with your luggage it would be chaos you may wonder what the impact would be in a hospital if they will use more barcodes well there's an interesting case study from the NHS hospital in Portsmouth in the UK they implemented barcode technology to better manage their inventories they could for example reduce very expensive inventory in their operating rooms by 20% but more importantly is that their caregivers could spend more time with patients and less time because they had to spend less time searching for the right products in fact the National Health Service expects they can easily save 1.3 billion dollars in costs per year simply by implementing this technology across English hospitals so barcode technology is there it's right under our noses who knows what else is there right under our noses I believe we have a great opportunity to learn from developing countries on how to think differently about innovation in healthcare by changing our mindset to look for simple solutions that are as safe and effective and that reduce cost by changing our mindset that more expensive is not always better in healthcare by changing our mindset to do more with less thank you

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