1. Professor Orla Hardiman HRB Clinician Scientist Innovation Its role in Delivering Better Health Outcomes

2. THE PROBLEM

3. Health Expenditure is Escalating

4. Anderson G F, Frogner B K Health Aff 2008;27:1718-1727

5. Use of hospitals

6. Population health triangle 5% 15% 80% Undiagnosed disease Healthy population with risk factors Disease Severity

7. We all the usual methods but it still wont work! We tried everything, but it still wont work! IRISH

9. INNOVATE! Latin: Innovare To renew or change

10. INNOVATION: Individual Barriers

11. INNOVATION: Institutional Barriers

12. INNOVATION IN THE HEALTHCARE WORLD

13. RATIONING HEALTHCARE BUDGET WHO? HOW? WHAT?

17. STAKEHOLDERS Society at large Healthcare professionals Industry Users (citizen/ patients)

18. SOCIETY

19. SOCIETAL INNOVATIONS IMPROVE KNOWLEDGE BASE Eliminate ineffective / inappropriate services –(How to define these?) Cut the volume of least cost-effective services –(How to define?)

20. Rationalize Services

21. Societal Innovations Strengthen Governance & Accountability

22. SOCIETAL INNOVATION (NEW TREATMENTS) Strengthened HTA but limited use in cuts –Evaluate the metric –Act on HTA recommendations European Network for HTA

23. INDUSTRY

24. INDUSTRY INNOVATION Drug Development –Reassess models Partnerships & Collective innovations

25. Disease State Gene locus / Environmental Cell Biology Animal Model Medicinal Chemistry In vitro therapeutic TARGETTED DRUG DEVELOPMENT Human trials In vivo therapeutic X

26. Failures in Translation “ Valley of Death”

27. PARTNERSHIPS Clinical Databases & “Deep phenotyping” Academic collaborations

28. INDUSTRY INNOVATION Personalized Medicine

29. Industry Innovation has Societal Implications

30. Challenges for Industry Pharma’s contract with society is a mainstream issue Industry survives because it is seen as socially useful. If that perception falters, so does the business model

31. MEDICAL PROFESSION

32. Innovation: Medical Profession Value of Preventative Medicine Power sharing Teamwork

33. Clinical Governance Recognise link between diagnostics, care and cost Clinical autonomy balanced with accountability Continuous quality improvement

35. Deming

36. EXAMPLE: EPILEPSY PROGRAMME Summary National Epilepsy Programme 36

37. THE PATIENT

38. The Citizen Patient Patient is an integral member of the team Patient as citizen has both rights & responsibilities Societal implications for how to ration

39. Innovation: The Patient as “Superconsumer” Autonomy –Knowledge about individual health status –Informed choices Ability to question / adjust /accept /reject treatments

40. IMPLEMENTATION

43. Challenges

45. Deming Cycle