In my 20 years of researching and teaching innovation, one consistent theme stands out: breakthrough innovation often comes from outsiders. To accelerate innovation in healthcare technology we need to give creative people who don’t have traditional health science backgrounds more opportunities to participate.
Outsiders often look at problems in new ways. They aren’t trapped by the paradigms and assumptions that have long become calcified in industry veterans. They often question (or ignore) assumptions that specialists take for granted. And they don’t have the investments that the veterans do in tools, expertise, or supplier and customer relationships that make change difficult and unappealing.
Take, for example, Gavriel Iddan, a guided missile designer for the Israeli military who invented a revolutionary way to visualize the gastrointestinal system. Traditionally, doctors have used a camera on the end of a long, flexible rod – an endoscope – to see inside the gut. This method is uncomfortable, and cannot reach large portions of the small intestine. Most gastroenterologists have invested in significant training to use endoscopic tools, and many have also purchased endoscopic equipment for their clinics. Not surprisingly then, most innovation in this domain has focused on incremental improvements in the rod, cameras, and imaging software.
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Iddan, however, approached the problem like a missile designer rather than a gastroenterologist. He did not assume we would need to control the camera with a rod, nor transmit images with a wire. Instead, he invented a capsule called PillCam that acts like a tiny missile a patient can swallow. It has power and light sources, and two small cameras. After ingesting the PillCam, the patient goes about her day while the device transmits images to a video pack worn around her waist. Roughly eight hours later, when she returns to the doctor’s office, a computer reads the images, and identifies any abnormalities (the PillCam exits naturally). Work on guided capsules is now well under way.
The device has proven to be safer and less expensive than traditional endoscopy (costing less than $500). It is also dramatically more comfortable. Patients have embraced the PillCam alternative; but getting doctors to adopt it has been harder in part because of their existing investment and familiarity with endoscopy. (Another consideration of course is efficacy; while traditional endoscopy is superior for certain applications, PillCam can do things that endoscopy can’t.) The PillCam is now sold in over 60 countries, and several companies offer competing products. It’s a remarkable solution to a difficult problem, and it is easy to see why it came from an outsider, rather than an endoscope maker.
Another outsider of note is Dean Kamen, who I profile in my book on serial breakthrough innovators, Quirky. Kamen may be best known for his Segway Personal Transporter, but he is a prolific medical device innovator as well. He invented the world’s first portable drug infusion pump which, among other applications, has revolutionized diabetes care. He also invented the portable kidney dialysis machine, the iBot mobility wheelchair that can climb stairs, and several advanced prosthetic limbs. Notably, he set about problem solving in each of these cases not because he had specific expertise in the discipline, but because he saw suffering that needed to be addressed. In fact, Kamen has no medical background, and never completed an undergraduate degree. He’s a tinkerer with a gift for electronics and engineering, and he did not let the typical barriers to medical innovation stand in his way.
Not every would-be healthcare inventor has Kamen’s resourcefulness and determination. Many will need a more obvious pathway for acting on their ideas. Most research shows that people tend to be penalized for crossing boundaries. We discount generalists and are suspicious of people who engage in activities that seem inconsistent with their identity. This makes it hard for specialists to cross fields, and even harder for those without science training to contribute their ideas. However, this is an area where there is enormous opportunity for improvement.
We can unleash innovation by creating ways for people with fresh ideas to access those with the expertise needed to refine or execute them. For example, research institutions could create expertise pools and consortia for sharing intellectual resources, and develop incentives for sharing the physical assets of science such as laboratories and equipment. Agencies such as the National Institute of Health (NIH) currently provide incentives for medical researchers to compete so vigorously against each other that they resist sharing resources or knowledge. I saw this firsthand when I was working with an Alzheimer’s researcher. After he failed to get an NIH R01 grant for two funding cycles, he could no longer afford to support the mouse colony at the center of his research. It had taken him more than two years to develop a strain with the traits he needed for his studies, but rather than give the mice to other teams working on similar problems, he destroyed them knowing he would be competing against those teams in the next grant cycle.
To foster these new types of collaborations, governments, businesses and research institutions should provide incentives for creating shared laboratories, build public labs designed to help non-scientists participate in science, and create public facilities to help individuals and small organizations navigate the complex and costly clinical testing process.
In addition, they should create programs that enable non-linear science careers. Currently, there is a strong bias in most science graduate programs to admit only young people, often right out of undergraduate study. Older people – for example, those changing careers or parents who have taken time off to raise children – are often not given full consideration. This bias imposes a huge opportunity cost on both would-be scientists and those who will benefit from their discoveries. With incentives and resources that foster collaboration and more inclusive access, we will see more rapid, efficient and creative progress in healthcare technology innovation.