HORIZON SCANNING- THE MEDICAL DEVICES OF THE FUTURE?

Andrew MarsdenScottish Health Technologies Group

Health Service Provider

Safety, Efficacy / Value, Guidance

Patient Unmet Need

Medical &Surgical Practice

Product Development

Applied Science

Pure

Science

COLLABORATE

• Trial/ In-Line Evidence Development

• Clinical Outcome Registries• Risk Sharing Deals• Strategic / Aligned procurement

Breakthroughs

Biology -

Chemistry

Physics

Mathematics & Computing

Developments

Medicine / Biomedical Research

Molecular Engineering

Bioengineering

Biomechanical / Mechanical Engineering

Bio photonics

Bioinformatics

Electronic,/ Electrical Engineering

IT / Computational Engineering

Software Engineering

Etc etc + Convergence & Complexity

Targeted Applications

Pharmaceuticals

IV Diagnostics

Imaging

Procedures

Biomedical Devices

IT & Communications

TRANSLATIONAL RESEARCH

COLLABORATION / INNOVATION

APPRAISING/ REGULATING

Health Technology Assessment (HTA)

NICE (1999) / SMC (2002)

ANTICIPATE

Horizon Scanning Centre

Patient Expectations

“Me Too”

TECHNOLOGY PIPELINE

Supported by and

Need

Adoption

Concept

Design

Horizon Scanning

CE mark

Evaluation

HTASHTG

NHSHIS

Procurement

NP

RegionalProcurement

HubsNHS

Boards

R&D

NIC

MHRA

Benefitsdemonstrated

Adoption Hubs

THE INNOVATION LANDSCAPE

THE HEALTH LANDSCAPE

• the quality agenda

– improve quality, reduce costs

• financial squeeze - pay freeze and reduction in tariffs

• pressure to reduce admissions to hospital

• better use of capacity; pressure towards concentration and specialisation

• integration of health and community care

WHAT DON'T WE WANT

• more of the same

• technical "solutions" to questions which have not been asked

• technology which poses its own problems and/or may not fit the Scottish context

• technology which in itself or through its consumables or whole-life costs may not be affordable

• more bells and whistles with rapid built in obsolescence

SO WHAT DO WE WANT AND WHAT NEEDS SHOULD BE ADDRESSED?

• the prevention of disease

• early detection of disease

• ambulatory care especially for an ageing population

• application to services closer to home, reflecting service re-design and integrated care pathways

• patient involvement, shared communication and linkage with informatics

AND HOW DO WE GET WHAT WE WANT?

• lower cost innovation using specialist centres with integration of resources for innovation

• early involvement of the end user (e.g. patient)

• earlier involvement of appraisal including economic appraisal within the technology pipeline

• new ways of looking at procurement including developmental procurement

• Small Business Research Initiative (SBRI)

MY BLUE SKY IDEAS FOR INNOVATIVE TECHNOLOGY

• a diagnostic "app" for long term conditions e.g. COPD or cardiac disease with full connectivity to primary care and hospital specialist departments

• patient ID and tracking system integrating with theatre, path lab, pharmacy, blood bank, supplies and HAI surveillance systems

• integration of diagnostic imaging with drug delivery systems

• more tissue-culture based biological implants rather than synthetic materialsthese technologies are all, in part, available now – but

should be fully integrated and in widespread use by 2020.