Managing New Technology

In the Military Health Paradigm

N-QLD Military Medicine Conference 4 Aug 2007

By LCDR Bob Curtis, RAN

AimAim

• Ensure that new medical technology is introduced to ADF DHS based on efficacy, cost-effectiveness and evidence.

• Harness the advancement in medical technology for better clinical quality and patient satisfaction in service delivery.

“In a survey of 3 large hospitals in Houston, Tx with a combined bed capacity of about 1400 beds, the avg No of medical devices being used per bed has increased between 1982 to 2002 from 4 devices per bed to 17 devices per bed”

IEEE Engineering in Medicine & Biology; Jun 2004

Technology Technology PhasesPhases

• Cutting (sometimes bleeding) Edge

• State of the Art

• Advanced

• Mainstream

• Mature

• In Decline(Popper & Buskirk, 1993)

Class 8 (Health)Class 8 (Health)

Ref: ADFP 703 Management procedures for Medical &

Dental materiel

• DMO

• HMLP

• Single Service Logistics Branches

• DNSDC

“There exists a significant relationship between flexibility, technology management and the various phases of technology management”.

Khamba JS, Flexible Management of New Technology

Health Tech Health Tech InnovatorsInnovators

• DSTO

• CSIRO

• ADF Capability Development Executive

• DHSD Capability Development Directorate• RPDE (Rapid Prototyping, Development & Evaluation)

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• Tertiary Institutions e.g. UQ Centre for Health Innovation Solutions (CHIS)

JP-2060JP-2060

ADF Deployable Health Capability • 4 Phases (so far) - 0 thru 3 ($250-350M)• Phase 3 - Deliver optimum quality services for the prevention,

treatment and evacuation of casualties by the adoption of a 'whole of system’ approach to the delivery of health support, addressing each of the following five Health Operating Systems: – preventive health; – treatment; – medical evacuation; – health information systems (C4IS); and – health services logistics.

JP-2060JP-2060

ADF Deployable Health Capability

• Facilitator – Delivery Mechanism:– Defence Materiel Organisation

• Good or Bad?• Tried & True!• All Class 8 Health Logistics

Systematic but Systematic but InnovativeInnovative

• Managing Technology requires discipline

• Ability to think ‘laterally’

• Combination of both concepts

• Systems Development Life Cycle (SDLC)

• “Delivering capability – not just equipment!”

SDLCSDLC

• Planning Phase

• Analysis Phase

• Design Phase

• Construction Phase

• Implementation Phase

• Post Implementation Review

• Maintenance

Rapid Applications Rapid Applications DevelopmentDevelopment

• Alternative to SDLC

• Phases:– Prototyping– Iteration– Time Limit (requirement, not deadline)– Rapid development (multiple players)– Practical acceptance as a key measure of

success

RPDE modelRPDE model

Triple Helix modelTriple Helix model

• Involving Innovative Enterprises• Create Innovative Environments• Create Disruptive Technologies• Accelerate Technology

Advancements• Promote Tech transfer and

commercialisation• Provide value

US DoD TATRC

SystemsSystems

• Healthcare is a system of systems

• Now - even down to the nano-level!

• Equipment level (i.e. technology) – in very near future – all be systematised!

• Each item will be ‘networked’ with their own ‘IP’ address.

SystemsSystems

• Synergistic relationship of:– Doctrine– Human resources– Training– Facilities– Equipment (technology)

• For the best results!

System ExamplesSystem Examples

• Hospital Information Systems

• Electronic Patient Records

• Pathology analysers

System ExamplesSystem Examples

• Radiology processors & PACS

• In / Outpatient Pt data capture

• Ancillary services

In conclusionIn conclusion

• DMO – will remain lead Agency

• No requirement to ‘reinvent the wheel’

• Improve the existing model

• Make it more dynamic & adaptive

• Greater awareness of ‘systematisation’

• Cutting edge but not necessarily bleeding edge!!