Stories about: clinical innovation series

Hacking pediatrics: Improving the patient experience

kids hacking-shutterstock_58262788Michael Docktor, MD, is director of Clinical Mobile Solutions at Boston Children’s Hospital and a pediatric gastroenterologist with a research and clinical interest in inflammatory bowel disease. (See a recent interview with him on MedTech Boston.)

How do the most disruptive companies of our day like Facebook and Pinterest get started? In the warm glow of Silicon Valley, in the shadows of technology titans such as Apple and Google, bright, enthusiastic young entrepreneurs, programmers and designers get together to “hack” ideas for the next big thing. The concept is simple and has worked in tackling challenges from creating the next great social network to developing an innovative green-energy technology.

However, applying this model of collaborative, rapid problem-solving to pain points in health care is still a relatively novel concept. Hacking Medicine, a community of passionate “hackers” at the Massachusetts Institute of Technology (MIT), has brought this practice to medicine and successfully organized events from Uganda to Boston. Graduates of one recent event with AthenaHealth—which develops and sells cloud-based services for electronic health records, practice management and care coordination—are on their way to developing successful businesses, including PillPack (helping patients manage their medications), the BeTH Project (inexpensive adjustable prostheses) and Podimetrics (a data-transmitting shoe insole for diabetics).

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How do you define innovation? Part VII

innovation-box-cropped-purchased-no-creditAs part of our ongoing effort to pin down this increasingly ambiguous term, five thought leaders offer their definitions of innovation, including the ABC News health and medical editor, Richard Besser, MD, and MIT inventor and professor Robert Langer, PhD—both of them keynote speakers at this month’s Pediatric Innovation Summit + Awards.

Please submit your definition to join the conversation!

Innovation in health is using new tools, approaches, or processes to improve or promote health, prevent illness and treat disease. —Richard Besser, MD, Chief Health and Medical Editor, ABC News

Innovation involves taking a creative approach to addressing a problem, often a persistent problem. It can produce a result where people say, “Why didn’t I think of that?” —Mark Schuster, MD, PhD, Professor of Pediatrics, Harvard Medical School; Chief of General Pediatrics and Vice Chair for Health Policy, Department of Medicine, Boston Children’s Hospital

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Surgeons have a responsibility to be innovators

Surgeons at workInnovation is inherent in surgery, says Thomas Krummel, MD, so for surgeons, the gap in launching an innovation isn’t the invention process but in the commercialization process. “Discovery and emerging technologies have shaped surgical practice from the start,” he said at a lecture at Boston Children’s Hospital this summer titled “Building on Robert E. Gross’s Legacy of Innovation.”

Krummel, who co-directs the Biodesign Innovation Program at Stanford University and and is Surgeon-in-Chief at the Lucile Packard Children’s Hospital, challenged his audience of residents and surgeons. “A surgeon in an academic department must pull a new rabbit out of his hat” with some frequency, he argued, pointing to historical examples ranging from the pulse oximeter to the more recent development of the video laparoscopic camera.

He also noted the variety of attitudinal approaches that surgeons can take to potential innovations. Some involve fear, and some surgeons try to ignore the potential for change, hoping it will go away. In Krummel’s estimation, “that is not a very surgical approach.”

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How do you define innovation? Part VI

Open box glowing with inner lightIn preparation for Boston Children’s National Pediatric Innovation Summit + Awards, we have asked thought leaders from beyond our walls to join our internal experts in a collaborative effort to define innovation from the perspective of pediatric researchers and caregivers. Add your voice to the comments, and register for our summit on Sept. 26-27 to join the conversation.

A new and unexpected idea, understanding, method or product that can be harnessed to solve a problem and improve our lives…It needs to go beyond an incremental advance – it should represent a “quantum leap.”
—Judy Lieberman, MD, PhD, chair of Cellular and Molecular Medicine, Program in Cellular and Molecular Medicine, Boston Children’s Hospital

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How do you define innovation? Part V

innovation box-purchased no creditThought leaders from beyond of the walls of Boston Children’s are coming together with our internal experts in a collaborative effort to define innovation from the larger clinical and scientific community. Add your voice to the comments—or register for our National Pediatric Innovation Summit + Awards (Sept. 26-27) and join the conversation.

 

Innovation is putting creativity into practice; but is much more complex than it sounds, as it requires development of an idea, testing and validation of an idea, creation of a product or process and defining how that can impact (in health care) a patient, and then commercializing or implementing that idea or process within the appropriate institutional context. Innovation continues to be in action, ideally with review and improvements over time. It can be as simple as changing how a patient makes an appointment to building the next surgical robot.
—Craig A. Peters, MD, Chief, Division of Surgical Innovation, Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Medical Center, Washington, D.C.

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Autism and Asperger’s are different… at least on EEG

Histogram differentiating EEGs of children with Asperger's and Autism
Asperger’s syndrome vs. autism spectrum disorders:
This histogram separates children with Asperger’s (in red) from those with autism spectrum disorders (green) based on EEG coherence variables. Although there is overlap with high-functioning autism, the Asperger’s children clearly form a distinct group. (Courtesy BMC Medicine)

Is it Asperger’s syndrome or is it autism? Since there are no objective diagnostic measures, the diagnosis is often rather squishy, based on how individual clinicians interpret a child’s behavior. According to the Diagnostic and Statistical Manual, fourth edition (DSM-IV), early problems with language development are an indicator of autism; if there are behavioral symptoms but no early language problems, the child has Asperger’s. However, if the diagnosis is made late, parents’ recall of early language development may be fuzzy.

Under the new DSM-V, published in May, Asperger’s is included under the general “autism spectrum disorders (ASD)” umbrella. This has raised concerns among families who feel their children with Asperger’s have unique needs that won’t be met in classroom programs designed for autism.

Frank Duffy, MD, a neurologist at Boston Children’s Hospital, believes it’s possible to objectively differentiate Asperger’s from ASDs using a new wrinkle on an old technology. Originally trained as an engineer, Duffy is expert at interpreting electroencephalography (EEG) signals—the wiggly lines that represent electrical activity in the brain.

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Stages for invention: Health devices and more from the next generation

Woman assembles Solarclave
Researcher Anna Young of MIT's Little Devices Lab works on a solar-powered autoclave for sterilizing medical instruments
(Image: Jose Gomez-Marquez)

“It’s a robot…it brings the remote.”

A kid in a striped shirt who looks to be going into the second or third grade reluctantly explains his cardboard and foam creation, a boxy figure with four wheels and a grabbing arm. He’s taken his invention from paper design through model through an imagined cover of TIME magazine, joined by countless other children who have designed everything from rockets to surprisingly detailed wind turbines.

I’m at the MIT Museum, and today it is overrun with inventors. Upstairs, younger visitors are invited to invent and model their own creations—like the remote-getting robot—and downstairs people gather to see presentations and prototypes by students working in MIT labs. This event is Insight into Innovation, the mad invention of the museum’s summer interns, and it’s a natural fit for MIT’s Little Devices Lab, a medical research group with a do-it-yourself twist whose offices are right above the museum. Three groups from that lab are exhibiting.

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How do you define innovation? Part IV

Innovation box-tight cropFrom the philosophical to the process-oriented to the curmudgeonly, here are more voices on innovation from our clinical and scientific community. Add your voice to the comments—or register for our National Pediatric Innovation Summit + Awards (Sept. 26-27) and join the conversation.

 

Innovation is the materialization of the notion that imagination is more important than knowledge. –Dario Fauza, MD, PhD, Associate Professor of Surgery, Boston Children’s Hospital

Innovation is the willingness to take the risk to embrace the unknown. –Clifford Woolf, MB, BCh, PhD, Director, F.M. Kirby Center and Program in Neurobiology, Boston Children’s Hospital

Innovation is the process of trying something new and the freedom to experiment—the antonym is to be stagnant. –Naomi Fried, PhD, Chief Innovation Officer, Innovation Acceleration Program, Boston Children’s Hospital

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How do you define innovation? Part III

innovation box-purchased no creditIs the realization of a good idea enough, or does innovation include getting others to adopt it? Atul Gawande, MD, considers this question in a thought-provoking New Yorker piece. In that spirit, our weekly series continues with some definitions of innovation that speak to the need for care in disseminating the idea or advance. (Gawande, by the way, will be keynoting at our National Pediatric Innovation Summit + Awards, September 26-27.)

Innovation is a disciplined approach by which a process or an object is improved, resulting in increased value. Central to this definition is rigorously identifying the essential stakeholders for whom the value will be generated and assuring the innovation takes into account their needs and preferences. Sometimes, these needs are implicit, and sometimes they are explicit. –Richard C. Antonelli, MD, Medical Director for Integrated Care; Medical Director Physician Relations and Outreach at Boston Children’s Hospital

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How do you define innovation? Part II

Supreme Court justice Potter Stewart famously said in 1964, referring to hard-core pornography, “I know it when I see it.” It’s become a phrase we resort to when we have difficulty defining a term or category.

Is “innovation” such a category, or can we precisely define it? Continuing our weekly series, here’s a few definitions penned by our clinical and scientific leaders, as a run-up to our National Pediatric Innovation Summit + Awards on September 26-27. Read on, watch the trailer and add your thoughts to the Comment section below.

Innovation is a two-step process. The first step is the realization that the key in your pocket, which you thought only opened someone else’s toolbox, may actually unlock the gate in the wall that confines you to conventional thinking. The second step is walking to the gate and turning the key.  —Joseph Madsen, MD, Director, Epilepsy Surgery Program, Boston Children’s Hospital

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