Medical Breakthroughs That Will Change Healthcare

You have to consider cost in the context of the benefit of improved outcomes and of the improvement in people's lives, UCLA's Feinberg says. "Our mission is to train the doctors of the future, to take care of patients, but also to discover tomorrow's cures. That's our core reason for existence . . . These firsts are what we exist for, and they have great societal benefit over the long term."

And then there's the business case: "We can't all afford to be early adopters," says Tom Hanenburg, CEO of the 168-licensed-bed Providence Medford (OR) Medical Center. "But if you're a lagging adopter, you're going out of business."

Technology, pharmacology, and clinical practice reimbursement all change meaningfully over time, and good hospital design requires careful consideration of those factors. Because predicting the future is so difficult, the chances are that you will make predictive errors, and, therefore, you must design as much flexibility into the building as possible, says Rabner, who is currently overseeing construction of a $447 million, 237-staffed-bed hospital to replace University Medical Center at Princeton, the system's aging acute care facility.

"One of our goals in developing the new building was to build in as much flexibility as possible," he says. The trick, he says, has been to put off final equipment decisions as long as possible, but not too long. "Technology continually evolves. All changes are not revolutionary but can have value. You do not want to decide too quickly and lose a useful feature or wait too long and have a building that can't easily accommodate the equipment you have selected," he says.

Every healthcare leader will eventually make a misstep. Many have bought a piece of equipment touted as the latest and greatest must-have item only to see it end up sitting in a back hallway gathering dust, says Hanenburg. "The way to avoid that is to really have some trusted clinical advisors who are willing to also adopt the technology and use it once you buy it," he says. "Identify your core physician leadership—the ones that you trust to guide you well in terms of the technology you're looking at."

Hanenburg says there are several factors to consider when weighing an investment. The first is clinical impact: Will it improve outcomes? The second is whether your physicians want it: Will they adopt it? The third is a little tougher to ascertain: Will insurance companies pay for the procedure and, if not, how long will it take payers to catch up to any given medical advance?

Leaders must take it upon themselves to prepare to answer these and other questions, says Sacred Heart's Ronstrom. "We have to make a personal commitment to staying informed and staying knowledgeable on medical developments," he says. "We need to invest in our organizations so that the staff can stay current with their education, [and] we need to appoint clinical leaders who are really smart about clinical efficacy." Innovation is "the direction we need to go in this country," he says. "The answer for our economy is to make investments in technology, not just walk away from it. This is how this country was built—on our innovation and our discovery."

Gienna Shaw is senior editor for technology for HealthLeaders Media. She may be contacted at gshaw@healthleadersmedia.com.

Gadgets Galore

A number of inventions, gadgets, toys, and smartphone apps could change the way we diagnose illness, improve safety, and communicate with patients. Here are just a few that caught our attention:

Nanotech-enabled sensors could someday sniff out cancer. Researchers have mapped the odor profile of certain skin cancers and are working to create a small electronic nose that can sense the airborne chemical pattern of skin cancer and other odors.

Researchers are working on a gel that spurs the growth of nerve cells. The gel, engineered with nanotechnology, fills the space between existing cells and encourages new ones to grow. This process could be used to regrow lost or damaged spinal cord and brain cells.

Smart pedometers wirelessly report data to physicians or physical therapists who can check it against patient's daily step-count goals.

Radio-frequency tags keep track of surgical sponges and other items that might be left behind when a patient is sewn up. One model identifies and counts items before and after each case and can determine exactly what items are missing. The system comes with a wand to scan the room (and the patient, if necessary) to help locate missing items.

People who were sent a daily text message reminding them to apply sunscreen had 60% adherence, according to a recent study at the Center for Connected Health at Partners in Boston. The control group had about 20%.

An iPhone app called the iStethoscope can record heart sounds and e-mail them to physicians anywhere in the world. Another app called PatientKeeper allows physicians to access patients' electronic medical records, including lab and test results, medication lists, and clinical notes.

And UnitedHealthcare recently released a free app that helps patients search its directory of doctors, clinics, and hospitals to find in-network care. After locating a provider, the app uses GPS to show the office on a map and provide detailed directions.

Although the virtual community Second Life has lost ground to other social networking sites such as Twitter and Facebook, the healthcare industry is putting virtual worlds to a variety of uses, from clinical training to patient communication, education, and support.

—Gienna Shaw