The archived InTimeTV video for the Insights in Medicine interview with Dr. Bernard Bendok (Assistant Professor of Neurological Surgery and Radiology at the Northwestern University Feinberg School of Medicine) is now available. We had a wide-ranging discussion of the basics of cerebral aneurysm disease and clinical management basics for general practitioners, ER physicians and others. For the full video clip, see: Advances in the Management of Cerebral Aneurysm Disease.
We discussed a number of topics including:
Ogan Gurel, MD MPhil
gurel@aesisgroup.com
http://blog.aesisgroup.com/
In this second part of a three-part series on innovation, we discuss the key elements involved in fostering innovation. The third part will focus more on accelerating development.
The previous installment of this series explored three basic points:
1. Innovation is different from invention
2. Innovation is the realization of invention
3. Innovation often results from a combination of inventions
In this regard, fostering invention – which is often done in places like basement university labs and garages – involves creating an environment of relatively unbridled freedom. To some extent relative isolation from the exigencies of the real world (and hence influence from conventional paradigms) is also beneficial. Ironically – as the phrase “necessity is the mother of invention” would indicate – globs of money are not required, and can actually inhibit, the process of invention. Because innovation involves the integration of multiple inventions and interdisciplinary combinations the factors involved in fostering innovation are quite different and in some ways almost opposite those that stimulate invention.
Obviously this is a complex topic, but here are a few high points.
Invention needs to be left free; innovation needs to be managed
It has often been said that invention abhors management and to some extent this is true. However, because innovation is intrinsically an interdisciplinary process, this is something that needs to be managed. There must be management (or something euphemistically similar to that) which needs to bring together different disciplines coherently and effectively. Of course, innovation management itself needs to think innovatively – namely to think broadly about what pieces need to be brought together and to conceive of the unusual combinations that make products successful.
The development of the drug-eluting stent at button-downed Johnson & Johnson, for example, is a case in point. Much of the role of management was actually involved in crossing the cultural barriers between the pharmaceutical and device sides of the company and in moving past administrative hurdles in order to make that project successful.
The process of bringing in innovative process also needs to be managed. Whether this is done in-house (as in the J+J example) or, via external partnerships (with the IBM PC project in the early 80’s) all this requires management.
Invention is often isolated; innovation is connected
Invention often proceeds in isolation from the outside world. In fact, it can be argued that being influenced by conventional paradigms is a disadvantage for those seeking invention. Einstein was one of the most inventive physicists in history and he developed his most revolutionary ideas away from the leading academic centers of the time. In fact, while he chafed at being “banished” to oblivion as a lowly patent clerk, it may very well have been as a result of being in such academic purgatory that he was able to come up with special relativity, the quantum mechanical explanation of the photoelectric effect and the description of Brownian motion in terms of atomic theory in one miracle year.
Innovation, however, requires almost the exact opposite. In order for inventions to make sense in the market and to be commercially viable, they need to be connected to reality. This is often the fallacy of corporate programs that aim to foster innovation in that by confusing invention with innovation they produce products that are recognized in their closed circles as being “brilliant” but nevertheless fail miserably in the market. This holds true for all manner of invention – including, for example, software development. To some extent, this phenomenon – among other factors of course – was an underlying reason for the dot-com bust. Software engineers were so enamored with their creations that apart from a disconnect with basic business principles there also lacked an appreciation for what worked with the market and consumers.
Innovation, therefore, requires the innovation management team to be highly attuned to the needs of the market and indeed, society more generally. Whether it be through attending conferences (especially those outside their field), customer focus groups, tapping into one’s diverse contacts, exposure to the media, etc. – all of these are elements of fostering innovation. To this extent then, the notion of being connected to the outside world, leads to the importance of marketing in fostering innovation …
Marketing: For invention product is key; for innovation product, placement, and promotion all need to be brought together
The classic 4P’s of marketing are product, placement, promotion and price. G. Pascal Zachary recently published a great article “The Unsung Heroes Who Move Products Forward” in the New York Times just this past week highlighting the importance of process innovations which complement and enable the inventive products they are built around.
At first blush, the iPhone from Apple, the new microprocessor family from Intel and the ubiquitous Google search engine have nothing in common. One is a gadget, one is an electronic part and one is a service. Yet all of these products — much acclaimed for their creativity — depend on obscure process innovations that, while highly complex and lacking glamour, are an essential part of establishing a winning edge in commercial electronics. Indeed, the success of Apple, Intel, Google and scores of other technology companies has as much or more to do with their process innovations as the products that inspire loyalty among fans and admiration from foes.
This is so true. The iPod for example, was to some extent, as an MP3 player a fairly unimaginative product. MP3 players had been around for quite a while so what was innovative about the iPod was primarily it’s user friendly design features and, very importantly, the development of the iTunes service (think placement and promotion) which enabled customers to actually use their iPods.
Fostering innovation, therefore, requires full engagement with marketing – not in the banal sense of advertising – but in terms of fundamentally reshaping or adapting the underlying inventive “product” into a package that truly meets the need of the market. This example, then, highlights the importance of innovation as a process which must be engaged with the outside world and one which the various disparate parts must be managed in order to be brought together productively.
Some of this may seem common-sense. And, indeed, that’s a good thing because ultimately innovation – if it is indeed the commercial realization of invention – must, however, revolutionary the underlying invention may be, make sense.
Ogan Gurel, MD MPhil
gurel@aesisgroup.com
http://blog.aesisgroup.com/
The archived InTimeTV video for the Healthcare Executive interview with Chester Szerlag MBA FACHE CMPE (Radiation Oncology Executive Administrator at the
We discussed a number of topics including:
· Demographic trends for cancer
· Technology trends in cancer care
· Strategic planning implications
· Integrating radiation oncology with other parts of the cancer care enterprise
· International health system comparisons with respect to cancer care
One important take-away was the importance of strong communication between healthcare executives and physicians.
Ogan Gurel, MD MPhil
gurel@aesisgroup.com
http://blog.aesisgroup.com/
The archived InTimeTV video for the Insights in Medicine interview with Dr. Peter Weiden (Professor of Psychiatry and Director, Psychotic Disorders Program at the
A recent CDC study showed that patients with severe mental illness die 25 years earlier (from general medical causes) than comparable patients without mental illness. As the psychiatric treatments have improved and while suicide still remains a cause of death for these patients, the general medical care for this population is taking on even greater, urgent importance.
We discussed a number of topics including:
Some important takeaways were:
Ogan Gurel, MD MPhil
gurel@aesisgroup.com
http://blog.aesisgroup.com/
As everyone knows – from Michael Moore to President Bush and all the various presidential candidates in between – our nation has a huge problem with the roughly 46 million who lack basic health insurance. This is both a humanitarian and economic problem which affects all of us. The basic premises of this proposal cover the following points:
Most of these points are pretty well accepted with the exception of the major problem – namely how one will pay for such a program. This is outlined in points #5 though #7 above and discussed in more detail below.
Jim Cramer: ‘Vice vs. Virtue’
On March 2, I saw a fascinating segment by Jim Cramer on CNBC’s “Mad Money”. Most of you may be familiar with Cramer’s wild and fiery style. This episode featured an intriguing study of “vice versus virtue”. Cramer presented a study in which 10 “vice” stocks (e.g. the “bad guys” such as tobacco, gambling and alcohol stocks) convincingly beat out a group of 10 “virtue” stocks (e.g. good corporate citizens such as IBM, Motorola,
The “bad guys” gave an equal-weighted return of 35.7 percent over the past year as compared to the “good guys” who were flat over the same period. Cramer argues that if you want to do good – and even this bastion of unabashed capitalism agrees that this is admirable – you are better off making money on sin stocks and then donating your proceeds to your favorite charity.
Are corporate returns (and, by extension, the stock market) truly reflective of a free market? Do the “bad guys” truly have to pay all costs related to their businesses? In economics, these costs – which are typically unaccounted for – are called externalities. These externalities can be positive when an external profit or benefit is created or negative when an external cost is paid for by others (e.g. by society rather than by the company). As an example with the tobacco industry, efforts through the courts and class-action suits have attempted to correct these externality costs. This has been largely ineffective and at best inefficient. While “sin” taxes also exist, these do not necessarily cover, for example, the externality costs of second-hand smoke or drunken driving. What would the comparative returns of “vice versus virtue” be if all costs were truly paid? While I would speculate that the “bad guys” may still do better, they certainly wouldn’t by as much.
A More Efficient Health Care Tax
Most Americans – with economists at the
Most state-based proposals to expand healthcare coverage are based on some form of across-the-board business tax. However, the concept of an across-the-board business tax does raise important questions and concerns as to whether this is the most efficient way to pay for universal health care. If one considers that some businesses create more of a health care burden (e.g. an externality) than others, it would appear that apportioning these taxes along these lines would be a more efficient and fair way to pay for universal health care. Here’s the proposal. It is simple.
For the purposes of funding health care for the working (or employable) uninsured (which is not the same as universal healthcare), businesses should be taxed according to their respective health care burdens on society.
This does not refer to the actuarial health care risk of a company’s employees – this is reflected in the company’s own health insurance rates – but rather the projected impact of the company’s activities and operations on the health of all citizens. The tax wouldn’t necessarily be equivalent to the estimated health care burden but rather proportional (relative to other companies) to that impact. Of course, one can counter that a vast bureaucracy would need to be created to validate and document such “health care burdens”. There is certainly enough health-impact data to make rough assessments for the purposes of taxation. One does not need to overanalyze in order to be efficient, and as a first step, identifying the “good, bad and ugly” should be fairly straightforward.
It is important to note that such taxation systems to account for externalities are not new. The “carbon tax” concept successfully implemented in many countries can serve as an example paradigm for such a system. In 1993, the
In order not to be unfair for the “unhealthy” companies – namely to avoid a double penalty – higher taxes for these firms should also come with legislated immunity against health-related class-action suits. While there should always be room for individual claims, many have argued that class-action suits of this sort are relatively ineffective and inefficient.
Under a proposal for increased health care taxes for “vice” companies, one can certainly argue in the face of a class-action suit that these companies are indeed paying their due to society. On the flip side, companies that actually contribute to the overall health of society should not necessarily be penalized by having to pay a health care tax that is equivalent to a company that generates a large illness burden. Such companies – such as hospitals, biopharma and medical technology companies – may end up paying very little or no such tax. The exact apportionment obviously needs to be calibrated to the mix of “virtue” and “vice” companies in the state as well as the overall funding needs of a comprehensive coverage plan for the uninsured.
A Healthier
There is also another very favorable consequence to this proposal. If we were to implement such an idea, we’d have an interesting scenario in which “unhealthy” companies would have additional incentive to minimize the adverse health impacts of their operations or even be encouraged to set up business outside the country. Certainly out-sourcing is a fact of life; while not necessarily friendly to other nations, at least many Americans may find agreeable the concept of outsourcing unhealthy businesses.
The
Benjamin Franklin once famously said: “In this world, nothing is certain but death and taxes.” Still, that doesn’t preclude optimizing (and not necessarily increasing) the latter in order to minimize the former.
Ogan Gurel, MD MPhil
gurel@aesisgroup.com
http://blog.aesisgroup.com/