Thinking about the clinical needs

When working with medical technology, it is always important to think about the clinical perspective of a device or method. It is necessary to pay attention to the patients and see what can improve the standard of care. Bearing this in mind, we can find the right needs to be addressed, making them broader or more specific as necessary; we can also validate hypotheses and theories, and especially make a bigger impact.

In order to innovate – or even improve the standard of care -, one need to find what is really important to do and the right timing to do it. Sometimes, what we see as a need is just a small part of the bigger problem that might be addressed, or is something really difficult to deal with, but that can be broken in smaller pieces which are solvable at time – and rarely, it won’t be a problem at all. In addition, we must understand if some technological development will be useful or will only generate small (even meaningless) improvement in the current setting. Finally, we have to evaluate if the value we are adding is worth (or, as economists would say, if it pays off the opportunity cost to be necessary in that setting). Hence, identifying the proper need is the most important step to start the development of a new project.

Robotic-assisted surgery (source: http://www.intellectualventures.com/)

After finding a good need, a solvable and interesting problem, one need to formulate hypotheses and theories. Those will be validated against the clinical understanding and outputs. Occasionally, what seems to be a plausible idea is refuted by observation or by understanding all the variables related to the problem – one case worth noting is the lack of significant improvement in surgical outputs with the use of robots (this does not mean they cannot help, but tells us that there are more important things to address). In other situations, there is already a solution in the setting, even though those responsible do not realize that – for example people adapting other instruments or changing the shifts order to gather more information and better treatment outcomes. This validation will always be present and is a continuous process; more data imply new analysis, new understanding of the setting and better hypothesis/theories/solutions – as described by Tim Brown in Change by Design. The clinical setting will give us the “error” criteria for the iterative process of innovation and research.

Finally, another important aspect of research is its capability of generating impact in people’s lives. Discovering what is really in need or comes in handy is essential, and it is only possible when researchers leave their comfort zone and dig deeper the reality of the clinical setting. In addition, the technological development can be meaningless if it does not have directly application to the healthcare – because the timing is not right or the device is not necessary/useful. Furthermore, one can lose money if does not address the right need because was not paying attention to patients, staff and other people before going too far in the development. Therefore, thinking about the clinical needs, identifying and addressing them properly are the most important aspects in health technology innovation – not how fancy or technological is your device.

(This text is a fragment of an article written as assignment for the class BME 566b)

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