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Ask the Experts: Is Innovating Within an Academic Medical Center Really Possible?

Jeff Greenberg

Jeffrey-GreenbergJeff Greenberg, MD, is the medical director of the Innovation Hub at Brigham & Women’s Hospital. He also practices medicine part-time at a patient-centered medical home.

Is innovation even possible inside an academic medical center, or should innovators move into the private sector?

It is entirely possible to innovate at an academic medical center. In fact, innovation is core to the purpose of many AMCs, which have been at the center of healthcare innovation for centuries. My own institution, Brigham and Women’s Hospital, performed the first kidney transplant and the first face transplant in the U.S. It and its peer institutions around the country have generated discoveries and inventions in basic science, clinical and translational research and in health care delivery. So it is more than possible; it is often essential. AMCs have cultures of discovery and innovation, a great deal of talent in clinical and non-clinical employees and, most importantly, patients. Patients are critical to pushing clinical innovation forward. AMCs excel at engaging patients in testing new ideas, through clinical trials, experimental procedures and care redesign efforts.

That said, the private sector is critical for innovation as well, and has some advantages over AMCs. Smaller companies and start-ups can move fast and can access equity markets more easily than AMCs, and are more experienced in bringing products and solutions to market. They may be more focused on doing one thing well, and doing it profitably. AMCs tend to be focused on many things, research, teaching and a broad spectrum of patient care, so may not be as single-minded in their pursuit of one great idea.

Why is innovating in academic medicine so difficult?

It is difficult because AMCs are huge institutions that do not move quickly. They have a variety of interests – research, teaching and patient care along with many departments and stakeholders. They are low-margin businesses and are understandably tight with cash. Funding innovative ideas that do not show a quick ROI is often difficult; much of the interest is in driving clinical revenue and securing research grants.

Additionally, the IP and equity rules within AMCs may not provide as large a reward for innovators who come up with novel commercializable ideas; often the institution takes a majority of the equity. Innovators may think they can do better to pursue their ideas unencumbered by these policies. But often the legal, IP and transaction support can be very welcome. At the Brigham, we are actively working to change the speed of getting things to ‘market,’ that is getting potential new therapies to patients quickly, in concert with industry. We want to build an infrastructure that supports clinical innovation/translational innovation and ideas of our junior faculty as well as world-renowned experts.

Q: Why do we still need to be pushing for innovation in academia?

Many of the great minds in health care work at AMCs. They are home to world-renowned researchers and labs, as well as clinicians with expertise in any human condition and the ways we treat them. Clinicians who know how to test drugs, devices, and IT platforms work at AMCs. And AMCs have patients, who are critical to developing innovative solutions. So AMCs have to play a central role in healthcare innovation. What precise role they play – in developing ideas, or in building them into companies or in testing them on patients – will evolve and change, and probably vary by AMC based on their individual interests, ecosystems and cultures.

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Jenni Whalen

Jenni Whalen

    Jenni Whalen is the Executive Assistant of Editorial at Upworthy. She was previously MedTech Boston's Managing Editor and has an MS in Journalism from Boston University, as well as a BA in Psychology from Bucknell University. Whalen has written for Greatist, Boston magazine, AZ Central Healthy Living and the New England Journal of Medicine, among other places. She has also worked as a conference planner, ghost writer, researcher and content developer.

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