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<h2 class="hd hd-2 unit-title">Bridging the Divide between Technologists and Healthcare Providers</h2>
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<h4>How can innovation improve health?</h4>
<p class="MsoNormal" style="mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; line-height: normal; background: white;">Interest in global health innovation and healthcare quality improvement has increased dramatically. Despite this interest, efforts to improve health in low-and-middle-income countries (LMIC), while well intentioned, have fallen short in several areas. Technological innovations have tended to be viewed as isolated solutions rather than tools integrated within larger programs of improvement. Technological innovations are appealing, particularly to entrepreneurial innovators. However, when applied indiscriminately to a weak healthcare infrastructure they can produce inconsequential or short-lived impact that falls far short of their potential to contribute to improved health.</p>
<p class="MsoNormal" style="mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; line-height: normal; background: white;">By nature, entrepreneurs tend to have several characteristics that make it difficult for them to solve systems-level problems. In particular, individualistic entrepreneurs tend not to reach out to other entrepreneurs to develop teams and they may view information as proprietary so as to preserve its business value. In contrast, the approach we propose requires the building of interdisciplinary teams and information sharing for the purpose of learning and establishing best practices. We believe such a change can best be accomplished by convening teams of teams, rather than entrepreneurs, to develop innovations that are thoughtfully combined to yield solutions greater than and unobtainable by the simple summing of individual parts.</p>
<p class="MsoNormal" style="mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; line-height: normal; background: white;">Non-communicable diseases, such as diabetes, hypertension, heart disease and chronic obstructive pulmonary disease, are overtaking infectious diseases such as tuberculosis, HIV/AIDS and malaria as health burdens around the world. They present a different set of challenges because interventions are usually required over a lifetime and patient engagement is key to better health. Innovations must also take into consideration factors that are typically considered external to healthcare delivery – education, poverty, mass media, transportation and communication infrastructure, political turmoil – as they affect the incidence of diseases and injuries, access to care and effectiveness of the care being delivered.</p>
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<p>The following videos in this unit are presented by:</p>
<p>Leo Anthony Celi MD MS MPH<br /><span style="font-family: 'Open Sans', 'Helvetica Neue', Helvetica, Arial, sans-serif;">Assistant Professor of Medicine, Harvard Medical School</span><br style="text-rendering: optimizeLegibility; line-height: 1.4em; font-family: 'Open Sans', 'Helvetica Neue', Helvetica, Arial, sans-serif;" /><span style="font-family: 'Open Sans', 'Helvetica Neue', Helvetica, Arial, sans-serif;">Principal Research Scientist, Massachusetts Institute of Technology</span></p>
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<h3 class="hd hd-2">What are the problems in healthcare?</h3>
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<h3 class="hd hd-2">Issues with “Evidence-Based Medicine”</h3>
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<h3 class="hd hd-2">Patient Safety</h3>
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<h3 class="hd hd-2">Concerns Over the Reliability of Medical Research</h3>
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<h4>Why technology fails in healthcare</h4>
<p>The hope that the many challenges that exist in global health will have technological solution is very seductive. Disappointments and failures are inevitable. One of the greatest obstacles facing global health is a failure of delivery. We cannot impose a technological solution on what is a problem of a weak healthcare infrastructure. Innovative products, whether they are medical device, software or drugs, are likely to have little impact unless incorporated into a relatively well-performing healthcare system. </p>
<p>Considering how innovations fit into the overarching health care infrastructure is crucial. We have enough cellphone applications, low-cost microscopes, glucometers, and all sorts of monitors. We have vaccines that don't require refrigeration, drug combinations that will improve adherence, and even mosquito-zapping lasers. But what we need are innovations that will integrate these components into systems that can be brought to scale. We need innovations in the delivery infrastructure that distributes and integrates care delivery most efficiently.</p>
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<p class="MsoNormal" style="mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; background: white;"><span style="font-family: 'Open Sans', Verdana, Arial, Helvetica, sans-serif;">With increased participation in global health among clinicians, public health workers, engineers and computer scientists, the risk of fragmented and redundant efforts among different professional groups is increased.<span style="mso-spacerun: yes;"> </span>Lack of coordination among well-intentioned professionals may represent a major obstacle to the goal of coordinating the tailored delivery of healthcare services and technology onto an organized health systems and institutional framework.<o:p></o:p></span></p>
<p><span style="font-family: 'Open Sans', Verdana, Arial, Helvetica, sans-serif;">Solving global health problems is not easy. We are not the first generation of innovators and entrepreneurs who have sought to improve global health. It will be pure arrogance to think that we are smarter than the previous generation. </span>We emphasize the importance of collaboration and the need to employ a multi-disciplinary strategy that matches innovative tools to the needs of the population. Such collaboration requires deliberate and thoughtful effort that may run counter to the intensely individualistic entrepreneurial spirit of many innovators who wish to lead global health improvement.</p>
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<p class="MsoNormal" style="text-align: justify; text-justify: inter-ideograph;"><span style="font-family: Verdana;"><span style="font-family: 'Open Sans', Verdana, Arial, Helvetica, sans-serif;">There are challenges to establishing a collaborative approach, most notably the organizational effort required to collaborate effectively and the preference of many entrepreneurs to focus on individual gain.<span style="mso-spacerun: yes;"> </span>In addition, professionals from different industries may have paradigms and practices that are difficult to interlace into new and different contexts. Finally, truly effective collaboration requires political leadership in both the organization and the government that can create and sustain the framework for an integrative approach that provides supportive policies, adequate financing mechanisms, and fair governance.<span style="mso-spacerun: yes;"> </span>Nevertheless, we believe that those who are able to follow a collaborative approach stand a far better chance of producing real and lasting improvements in health.<span style="mso-spacerun: yes;"> </span></span><o:p></o:p></span></p>
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<h2 class="hd hd-2 unit-title">Accelerating Innovation in Health IT</h2>
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<h4>Accelerating Innovation in Health IT</h4>
<p>Anyone who works regularly in the medical system will agree that healthcare informatics innovation is lagging. Antiquated paging systems and cumbersome electronic health records are the norm, and despite millions of dollars being poured into health technology and a clear need for innovations, we have not seen the progress we would expect.</p>
<p>In the September 2016 article in New England Journal of Medicine titled "Accelerating Innovation in Health IT", Rudin et al. argue that this gap in innovation is due largely to the divide between the engineers, designers and computer scientists who have the skills to develop new IT products, and the doctors, nurses, and patients who have the deep understanding of the day to day needs and challenges of the medical system. Working in isolation, IT professionals will often form very technologically sophisticated tools that do not fit into a complex hospital workflow and so are doomed to fail. It is only by forming multidisciplinary teams, and by bringing these two groups together that we can hope to form meaningful, lasting innovation.</p>
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<p>The following video in this unit is presented by:</p>
<p>Alon Dagan MD<br />Beth Israel Deaconess Medical Center, Department of Emergency Medicine<br />Laboratory for Computational Physiology, MIT</p>
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<h3 class="hd hd-2">The Divide Between Clinicians and IT</h3>
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<legend id="9f183363da4e49bfb855561d5ce8ce36_2_1-legend" class="response-fieldset-legend field-group-hd">What are some of the benefits of a collaborative effort between health IT developers and clinicians?</legend>
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