At times, when facing new alternatives in healthcare, we have thesensation of traveling back in time. It seems that some procedures we have adopted in the past have came back to fashion. I hear remarks that health technology is cyclic, like a wave; however, in the long-term, this would mean improvement would be linear, a flat line. I also hear that some good ideas come and go, meaning that we would be moving in circles, trying to catch our own tails. But that is not the way I understand it. I prefer to build a 3D situation. Health science really goes around causing a cyclic déjà-vu sensation but, like a “spring” growing up towards the sky, the end of the line never touches were it began. The gap between these two points that were supposed to touch each other is widened by new or more affordable technologies developed for that procedure. Sometimes these technologies are so interesting for science and industry that this ‘spring’ starts to become wider and wider. A huge amount of research is developed, enhanced by market power, turning our ‘spring’ into a mushroom-shaped view of science.
When Professor Sir John Charnley performed the first total hip replacement, in England, in 1962, one of the most successful of all surgical procedures for the management of end-stage painful human condition was reached, offering relief to thousands of osteoarthritis sufferers. Some believe serendipity played a role in this marvelous insight, but it did not. Many surgeons and industry had envisioned that for years, and hard work, time and new technologies finally led to success. The medical society acclaimed that solution, and industry ran to make it better. Research to foster better results, so as to last more than the 15-20 years that Charnley prostheses would normally do drove science and industry to the use of different materials like titanium, ceramic, plastic, oxynium and even biomaterials. Billions of dollars have been invested in R&D every year for this purpose, leading the spring to become a huge mushroom. However, they still last 15 to 20 years. Conversely, gigantic improvements were made allowing for less aggressive approaches, bringing forth faster recoveries and minimizing undesired secondary effects or complications. Also, irradiating know-how beyond borders allowed more people to be treated and creating a scale market for entrepreneurs, thus resulting in more affordable technology. The spring goes round again.
Thinking in this manner, one could say that health innovation would be almost predictable; this is not true, however. We live in a world where intellectual, economic, and political borders start to be surpassed by easy, fast and affordable communication. Away from the prospective, but heavy loaded, rich soil of Universities and from the self-interested industrial research, we are now able to catch, early on, evidence-based insights popping out like seeds from these many scientific mushrooms, sprinkling this fertile gap. The future of innovation in health lies on creating intelligent tools to identify these motivated laborers and enforce their basic needs, because the ‘vanguard scientific minds’ are still the most valuable devices: bringing simple solutions that may break paradigms, thus opening up new paths for science and entrepreneurs.
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