Innovation in healthcare services
London Views talks to Kamalini Ramdas about her research into healthcare innovations and how these innovations may help to provide a means for healthcare systems to provide more services with less resources.
Healthcare systems throughout the world are facing enormous funding challenges. The clarion call from political parties of all sides for healthcare is to provide more services with less resources. To many inside and outside of healthcare this seems an unreasonable demand and an impossible task. But, while there are no easy answers, innovations in healthcare services may provide a means of squaring the healthcare circle. Georgina Peters talks to Kamalini Ramdas, about her research into healthcare service innovations.
The obvious opening question is how a Professor of Management Science and Operations comes to be looking into healthcare?
Over a number of years my research examined standardisation in assembled products like automobiles. Next I began exploring the impact of standardisation in services. And then I had an accident skiing. This led to knee surgery and over a month in bed. That was when I had a realisation that perhaps there might be some implications for standardisation in the area of medical devices.
Intrigued, I talked to my surgeon and persuaded him to let me observe a knee replacement operation. This gave me a better understanding of how the process works. Then I spoke to a large number of people, other surgeons, faculty in the bio-engineering department of the University of Virginia, doctor friends, and others. I singled out device choice as a good place to begin to understand standardisation in this entirely different sphere.
So you are bringing your knowledge of processes and applying them to healthcare?
Yes. Clearly, a surgeon is more extensively qualified than a car assembly line worker. But, whether you are a surgeon or a car assembly worker, the basic principle is much the same: when you do more and more of the same type of procedure, you get better at it. Similarly, if you think about how car components need to be designed for different cars and cars have different characteristics, the devices that are used in hip surgery, for example, need to be well tailored to the patient they’re used on and people come in a huge spectrum of different shapes and sizes.
It is also worth emphasising that service innovation is more challenging than product innovation because of the range of stakeholders involved.
Who did you work with on this research?
I did this work with Dr Khaled Saleh, an orthopaedic surgeon and professor at the Southern Illinois University School of Medicine and with an economics professor, Dr Steven Stern, also at the University of Virginia and Haiyan Liu also from the University of Virginia. In the surgical setting we were interested in examining how the experience that surgeons have with specific components affected the outcome of the surgery, for example, whether or not the surgery would result in a revision. In addition, we took into consideration whether the device was a good fit for the individual patient it was used on.
The outcome we were looking at was whether or not a revision occurred. The rate of revisions is actually quite low. As a result, we decided to focus on the amount of time it took to do the surgical procedure. In hip replacement surgery the amount of time that the surgery takes is actually a very important variable. If you think about infections that occur during surgery, the chances of an infection are directly proportional to how long it takes to do the surgery.
And what were the other conclusions of your research?
One thing that came out of our study was an understanding of what kind of experience actually matters. You want to go to a surgeon who has a lot of experience but the specific type of experience the surgeon has with particular devices is what matters. In hip replacement, for instance, surgeons use cemented and uncemented devices for the procedure. So it matters where their experience is.
In the United States there have been discussions in the Senate discussing standardising the components used in surgery. Understandably, the device manufacturers have been up in arms about this because they’re worried about how standardisation might affect their product lines. Our research may contribute to this debate.
The reality is that research on the standardisation of components is applicable to almost any assembled product company where you’re making a product that comes with assembly components. In addition it is also applicable to services where you are trying to serve different customers or market segments and there are certain parts of the service or certain tasks that can be standardised.
You are now planning to develop these interests with an event in July?
Yes, we are holding a one-day symposium on “Innovation in Healthcare Services” on July 16th. Basically, the healthcare system is facing huge funding challenges. Service-based innovation will be a major component in reducing costs and improving outcomes. But, the challenges are immense for healthcare leaders who must identify, prioritise and drive through these innovations. Service-based innovation is more complex than product-based innovation precisely because it requires change from within with all the associated technical, political and cultural issues.
Who are the thought-leaders in this field?
What is really exciting is that we have attracted many of the opinion formers in innovation in healthcare services. They include Elizabeth Teisberg from the University of Virginia who co-authored a bestselling book on the future of healthcare with Michal Porter. Toby Cosgrove from the Cleveland Clinic is also speaking and Axel Unger from the groundbreaking design company, Ideo, is also explaining how design can improve user experiences and outcomes in healthcare. It is a crucial issue at a critical juncture so it is really satisfying to be contributing to the debate.
Kamalini Ramdas is a London Business School Chaired Professor of Management Science and Operations. To find out more about the Innovation in Healthcare Services Symposium, please email Professor Ramdas (kramdas@london.edu).