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Innovation in healthcare

Medical technology innovations - what else can they lead to?

  • Sebastian Barnutz
  • Christoph Koch
  • Thursday, 20. June 2024

Current medical advances are not limited to artificial intelligence alone. Which health tech innovations are the most promising? And how do organizations ensure that they recognize innovations at an early stage and make the best possible use of them?

Every person is unique – and yet the principle of the lowest common denominator is often applied in medicine. From diagnosis and therapy recommendations to the dosage of medication, a lot is based on average values and “one size fits all” solutions. But this is changing: medicine is on the cusp of a revolution that has the potential to forever change the treatment of diseases. So-called personalized medicine promises a future in which therapies are tailored to the individual and based on their genetic or molecular characteristics. Especially in the fight against cancer, one of the most complex and multifaceted diseases of our day and age, personalized medicine is opening up completely new possibilities and bringing new hope.

The example of CRISPR technology shows the curious detours by which medical innovations are sometimes born. This ground-breaking technology began in a very pragmatic way: when researchers from the dairy industry were looking for a way to protect the starter cultures of yoghurt and cheese from attack by harmful viruses, they almost unintentionally came across the sequence repeats in the genetic material of bacteria that help them defend themselves against viruses. And that gave CRISPR its name: Clustered Regularly Interspaced Short Palindromic Repeats.

Gene scissors against hereditary diseases

Janice Chen, long-time CRISPR researcher and co-founder and Chief Technological Officer of the US biotechnology company Mammoth Biosciences, also reported on these beginnings at the SXSW Innovation Conference in Austin, Texas, in March this year. Chen completed her doctorate under Nobel Prize winner Jennifer Doudna at the University of California, Berkeley and has since co-developed and patented numerous CRISPR technologies. In a talk entitled “How Gene Editing Is Fueling A Health Revolution”, Chen described the great progress that CRISPR technology has made since its yoghurt beginnings. “Our understanding of the human genome has made gigantic progress as a result,” Chen pointed out.

One of the first practical applications of a technology often described as gene scissors is the treatment of the hereditary disease sickle cell anemia, which was previously considered difficult to treat. With the help of CRISPR technology, it will soon be possible to remove stem cells from the affected person, modify them in the laboratory, and transplant them back into the patient’s spinal cord. The procedure is still relatively lengthy and expensive. “But the big advantage is that it is a one-off intervention – unlike medication, which you have to take and pay for over your whole lifetime.”

Organization vs. innovation

In addition to this example, numerous other types of medical innovation were also discussed at SXSW – and strikingly often in the fields of cancer research and personalized medicine. But how can companies and other organizations ensure that they recognize innovations of any kind at an early stage and make the best possible use of them?

Here it can be useful to differentiate between innovations that change an organization itself – for example, new forms of collaboration or process innovations – and innovations that affect a specific industry, are triggered by a technological leap and change or even make business models obsolete, open up completely new business areas, or at least necessitate a general rethink. While remote working or specific software tools such as Slack, Asana or Canva are examples of innovations that change organizations, electromobility or a new cancer therapy would be innovations that primarily affect organizations in the respective industry.

What both types of innovation have in common is that they disrupt an organization’s established processes. Most innovations do not actually fail due to a lack of ideas or quality, but because they slip through an organization’s cracks. This is because organizations are almost always more geared to routine, predictability, and reproducibility than generating new, ground-breaking ideas. In the vast majority of cases, innovations therefore have to be first actively introduced into an organization – often in the face of resistance or the phlegmatic “But we’ve always done it this way”. From an organizational sociology perspective, you could even say that having a glorious idea is the easy part. Ensuring its survival within an organization is much harder – because the idea may not even be given a hearing, may be talked down, may be the victim of micro-political battles, or may be rejected on the grounds that it has all been tried out in the past. You could even say that organizations are the natural enemy of innovation.

Phases of innovation

In order to implement innovative ideas within an organization – either those that affect its way of working or innovations in the respective organizational field – various things are important. In order to create a framework that facilitates the implementation of innovative approaches, it is necessary to understand an organization’s inherent logic and make it innovation-friendly. Furthermore, you need to understand the various phases of the innovation process and not only take into account an organization’s formal structures but, in particular, its informal ones.

The innovation processes within an organization typically run in three phases: variation, selection, and re-stabilization. The variation phase initially involves doing something different than what was done previously. A small group goes off the beaten track to try out something new. Selection, the second phase, is about following on from the variation phase. This means that the innovation must be accepted by relevant players in the organization and thus seen as a fundamentally sensible proposal – in other words, something that can be tried out and, if necessary, pursued further, but which is still considered an exception or deviation from the status quo. In the third phase, re-stabilization, this exception either becomes the official rule or may be pursued informally.

Each of these phases is important. In the variation phase, organizational members take risks by showing initiative. In the selection phase, the organization’s immune system kicks in and micropolitical battles ensue. The third phase is about the fact that innovation will not become permanent by itself. Some previous structures and routines have to be actively unlearned to make room for the ‘new normal’ or avoid excessive contradictions.

Fears and risks

This is all much easier said than done, especially as the glittering new world of innovation usually competes with unglamorous but the essential day-to-day business that has to carry on functioning. As useful as it can be to introduce new processes and try out new methods, and as important it is not to close your mind to innovation, you cannot, for example, simply close down a hospital until all the innovations have been set up, as required, on site. During a SXSW panel on “AI, Health Care and the Strange Future of Medicine”, Dr Mark Sendak, a leading data scientist at the U.S. Duke Institute For Health Innovation, also commented on how difficult it is to find the right balance between incremental (i.e. step-by-step) and more radical innovation: “People often expect something new to fit seamlessly into an existing system. But sometimes it can also make sense to rethink the whole setup, how certain processes and tools are defined, and so on. There is a lot of hidden potential in this.”

If you want to introduce something new into an organization, you will often be confronted with fears – fear of change, fear of the unknown, fear of the uncertainty that new things bring with them. Ignoring such fears or simply brushing them aside is rarely a sensible move. But it is important to differentiate between the real and perceived risks of innovation. As an example of a real risk involved in CRISPR technology, Janice Chen pointed out that if this technology falls into the wrong hands, it could be used to reprogram certain pathogens to make them even more infectious and more dangerous: “Yet more often we hear the objection that someone could use CRISPR to breed superhumans or the smartest babies. Right now, we don’t even know how intelligence is genetically coded, let alone that we could influence it.” In the final analysis, the chance of one day curing thousands of genetic diseases with CRISPR outweighs even the more realistic of these two risks.

Weighing up real and perceived risks is probably most crucial in the selection phase. This is the moment when what is “possibly quite nice idea” may well turn into “this is how we will always do it from now on”. This decision should not be based on false assumptions and unfounded fears. Whether we are talking about medical technology or other innovations, it is just as important to take the cautious people in an organization along as it is the optimists and fast enthusiasts. And just like every person, every organization is unique.

Sebastian Barnutz

Dr. Sebastian Barnutz

is a partner at Metaplan and he designs organizations for clients in the health care sectors.

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Christoph Koch

is a journalist (brand eins, Süddeutsche Zeitung Magazin, etc.), SPIEGEL bestselling author (e.g. “Digital Balance”) with a focus on the impact of Artificial Intelligence.

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