BLOG: Three questions for any medical innovation

ByJohn A. Hovanesian, MD, FACS

In the cover story of this issue of OSN, we explore ophthalmologist-entrepreneurs and their innovations. Our specialty has many bright minds who have changed medicine forever. As a specialty, ophthalmology may be particularly receptive to innovation because those who enter eye care are self-selected for being open to new ways of thinking. After all, we left medical school, knowing much about the human body, only to concentrate on an extremely limited area with new anatomy, new terminology and new diagnostics. We are also a tech-oriented bunch by nature.

Starting my own ophthalmology software company, MDbackline, has been a wonderful challenge for me personally, and we always try to meet and exceed these three questions I think we should ask of every new offering we consider:

1. Does it substantially improve upon existing technology? As physicians, we are wary of reformulated drugs that take an old compound and deliver it in a new way. These incremental innovations do add some value, but it is often hard to justify their high cost in relation to the small added benefit (see my blog titled “Is price no object if someone else is paying?”). To be successful, an innovation should ideally be self-evident as an indispensable tool that every doctor would want to use.

2. Does it serve patients, physicians and industry in that order? Unless all three gain meaningful benefit, the product will lack “stickiness” that may prevent it even from being developed or funded, and it will certainly face barriers to adoption in the real world. For more on this, including examples, see my blog titled “Successful innovations benefit industry, practices, patients.”

3. Does it add or subtract work for doctors? Doctors’ time is so squeezed by rising demands that any successful technology should save rather than cost time. I know many surgeons who will not adopt premium IOLs because they simply require too much time relating to patients. OCT scanning, on the other hand, takes little physician or staff time and yields significant information that could not be obtained before. Not surprisingly, the latter has become standard of care while the former has grown more slowly than many expected.

With my own software company (www.MDbackline.com), we help doctors by conducting automated follow-up care on common conditions such as dry eye, postop outcomes after cataract surgery and ensuring compliance among glaucoma patients. Nothing like this has existed in the past (question 1). Patients benefit by learning information that’s too time-consuming for physicians or staff to convey, while physicians gain increased reimbursement through data that meet meaningful use criteria and allow better contract reimbursement (question 2), and physicians and their staffs tell us that they save about 30% of their time previously spent on phone calls answering questions (question 3). Fortunately, we are growing, and we certainly owe part of this growth to our focus on these three questions.

There are other worthy tests that determine whether an innovation will succeed. Indeed, the idea is the easiest part. Executing a plan is always where the challenge lies, but I would encourage everyone to consider these three tests when evaluating any new offering in our specialty.

Disclosure: Hovanesian reports he is the founder of MDbackline.