Advancing the Public’s Health by Scaling Innovations in Clinical Quality

Malcarney, Mary-Beth; Horton, Katie; Seiler, Naomi; Hastings, Deborah

doi:10.1177/0033354917709982

Cited by 4 publications

(4 citation statements)

References 40 publications

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“…Leaders should drive continuous stakeholder engagement from patients to policymakers and disseminate the evidence and lessons learned to ensure all perspectives are heard (Greenhalgh et al, 2004 ; Chanfreau-Coffinier et al, 2019 ; Shih et al, 2022 ). This would ultimately build credibility and drive compatibility of the innovation with the regulatory and access process (Malcarney et al, 2017 ).…”

Section: Scaling Solutions To Healthcare Data Requires Pragmatic Rati...mentioning

confidence: 99%

Challenges and solutions to system-wide use of precision oncology as the standard of care paradigm

Lajmi,

Alves-Vasconcelos,

Tsiachristas

et al. 2024

Camb. prisms Precis. med.

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The personalised oncology paradigm remains challenging to deliver despite technological advances in genomics-based identification of actionable variants combined with the increasing focus of drug development on these specific targets. To ensure we continue to build concerted momentum to improve outcomes across all cancer types, financial, technological and operational barriers need to be addressed. For example, complete integration and certification of the ‘molecular tumour board’ into ‘standard of care’ ensures a unified clinical decision pathway that both counteracts fragmentation and is the cornerstone of evidence-based delivery inside and outside of a research setting. Generally, integrated delivery has been restricted to specific (common) cancer types either within major cancer centres or small regional networks. Here, we focus on solutions in real-world integration of genomics, pathology, surgery, oncological treatments, data from clinical source systems and analysis of whole-body imaging as digital data that can facilitate cost-effectiveness analysis, clinical trial recruitment, and outcome assessment. This urgent imperative for cancer also extends across the early diagnosis and adjuvant treatment interventions, individualised cancer vaccines, immune cell therapies, personalised synthetic lethal therapeutics and cancer screening and prevention. Oncology care systems worldwide require proactive step-changes in solutions that include inter-operative digital working that can solve patient centred challenges to ensure inclusive, quality, sustainable, fair and cost-effective adoption and efficient delivery. Here we highlight workforce, technical, clinical, regulatory and economic challenges that prevent the implementation of precision oncology at scale, and offer a systematic roadmap of integrated solutions for standard of care based on minimal essential digital tools. These include unified decision support tools, quality control, data flows within an ethical and legal data framework, training and certification, monitoring and feedback. Bridging the technical, operational, regulatory and economic gaps demands the joint actions from public and industry stakeholders across national and global boundaries.

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Section: Scaling Solutions To Healthcare Data Requires Pragmatic Rati...mentioning

confidence: 99%

Challenges and solutions to system-wide use of precision oncology as the standard of care paradigm

Lajmi,

Alves-Vasconcelos,

Tsiachristas

et al. 2024

Camb. prisms Precis. med.

View full text Add to dashboard Cite

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“…Trust is associated with a system’s performance and ability to improve outcomes. Scaling innovations for increasing adoption by clinician- and patient-mandate large investments is a significant challenge [ 168 , 169 ].…”

Section: Challenges In Healthcare Systems That Need To Be Accounted F...mentioning

confidence: 99%

“…Who is responsible for the consequences if an AI system provides an incorrect diagnosis or treatment recommendation? Several parties are involved, including the developers of the AI system, the healthcare providers who use the system, and the affected patients [ 168 , 169 ]. If an algorithm misses a diagnosis that a physician accepted, the consensus is that the professional is liable if the tool was misused [ 170 ].…”

Section: Challenges In Healthcare Systems That Need To Be Accounted F...mentioning

confidence: 99%

The Constrained-Disorder Principle Assists in Overcoming Significant Challenges in Digital Health: Moving from “Nice to Have” to Mandatory Systems

Hurvitz,

Ilan

2023

Clinics and Practice

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The success of artificial intelligence depends on whether it can penetrate the boundaries of evidence-based medicine, the lack of policies, and the resistance of medical professionals to its use. The failure of digital health to meet expectations requires rethinking some of the challenges faced. We discuss some of the most significant challenges faced by patients, physicians, payers, pharmaceutical companies, and health systems in the digital world. The goal of healthcare systems is to improve outcomes. Assisting in diagnosing, collecting data, and simplifying processes is a “nice to have” tool, but it is not essential. Many of these systems have yet to be shown to improve outcomes. Current outcome-based expectations and economic constraints make “nice to have,” “assists,” and “ease processes” insufficient. Complex biological systems are defined by their inherent disorder, bounded by dynamic boundaries, as described by the constrained disorder principle (CDP). It provides a platform for correcting systems’ malfunctions by regulating their degree of variability. A CDP-based second-generation artificial intelligence system provides solutions to some challenges digital health faces. Therapeutic interventions are held to improve outcomes with these systems. In addition to improving clinically meaningful endpoints, CDP-based second-generation algorithms ensure patient and physician engagement and reduce the health system’s costs.

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“…The pursuit of innovation in health and social care at the national level has been a longstanding goal (Mossialos et al, 2018, Flessa & Huebner, 2018, with key stakeholders constantly facing challenges in overcoming the inertia and complexity of existing structures (Greenhalgh et al, 2017), limited opportunities for experimentation (Fleuren et al, 2004), and difficulties in disseminating successful ideas (Malcarney et al, 2017, Yusof et al, 2008.…”

Section: Innovation In Health and Social Carementioning

confidence: 99%

Developing a National Research and Evidence Base for the Health and Wellbeing Chapter of the Welsh Government’s 2023 Innovation Strategy for Wales.

James,

Rees,

Thomas

et al. 2023

ECIE

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This paper presents research informing the Welsh Government’s (WG) Health and Wellbeing chapter of the new Innovation Strategy for Wales (ISW). WG recognises the need for a cross portfolio Innovation Strategy to bring greater coherence and alignment to our existing Welsh health and social care innovation ecosystem, particularly in a post EU environment. This approach aims to support greater collaboration between healthcare, industry, academia and the third sector to deliver greater impact and value (Davies et al, 2021) by developing, sharing and adopting innovative practice, leadership and skills development and supporting new technology development (WG, 2018). As part of the development process, key stakeholders were identified as part of an innovation ‘push’ and innovation ‘pull’ nexus (Chesbrough, 2003) approach. Organisations were categorised into domains of health and social care providers, innovation infrastructure, technology platforms, innovation centres, and partnerships across Wales’s health and life sciences ecosystem. A qualitative, action research led approach was used to derive the key themes supporting development of the ISW health chapter. Multi-sector consultations were conducted with experts from various fields, including health, social, care, research, and technology. Our analysis of qualitative data collected through an extensive consultation process led to the emergence of areas of prioritisation for the ISW. Three areas of prioritisation were identified in the analysis: Creating coherency across the innovation ecosystem, where every partner understands their role. Focusing innovation activity on NHS Wales organisational needs/priorities, generating ‘Innovation Pull’. Creating an ‘adoption ready’ pipeline of innovation externally into health and social care at scale, creating an ‘Innovation Push’ offer. The ISW aims to create the optimal conditions for an innovation ecosystem underpinned by clear infrastructure and a robust policy framework, which has the full support from health and social care leadership, to create a culture of innovation at all levels of the health and social care system. The ISW was launched on 27th February 2023, with full political support from the Welsh Government Cabinet; a majority Labour party government supported by the Plaid Cymru party, as part of the Welsh Government’s 2021 election cooperation agreement.

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Advancing the Public’s Health by Scaling Innovations in Clinical Quality

Cited by 4 publications

References 40 publications

Challenges and solutions to system-wide use of precision oncology as the standard of care paradigm

Challenges and solutions to system-wide use of precision oncology as the standard of care paradigm

The Constrained-Disorder Principle Assists in Overcoming Significant Challenges in Digital Health: Moving from “Nice to Have” to Mandatory Systems

Developing a National Research and Evidence Base for the Health and Wellbeing Chapter of the Welsh Government’s 2023 Innovation Strategy for Wales.

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