Finding unmet healthcare needs

Despite being 1) an engineer; 2) a man; and 3) having zero professional medical experience, this week I began observations in a gynaecology and obstetrics department.

Four weeks ago, I became a Fellow on the Novo Nordisk Foundation BioMedical Design Fellowship. Since the start of the programme, I - and the seventeen other fellows - have received a thorough introduction to the many facets of value creation within healthcare.

The 2022/23 BioMedical Design Fellows at the kickoff event in Middelfart. The fellowship admits a diverse group of individuals, with backgrounds varying from a range of medical disciplines to managers within large multinational companies.

We’ve covered most of Denmark for a range of workshops and seminars on a variety of topics including need statements, health economics, MedTech innovation, the Danish healthcare system and more.

In between we’ve met and spoken with numerous experts and advisors; been onboarded at our clinical hosts; and even found the time to get to know each other.

The ultimate objective of the programme is to produce impactful healthcare innovations, built on a foundation of in-clinic observations, the first ‘proper’ phase of the programme (Clinical Immersion).

The central aspect of needs-based innovation is what initially drew me to the programme. All too often, and speaking from painful prior experience,  this problem-identifying step is rushed, or ignored completely.

This emphasis on problem finding, combined with a cohort of skilled fellows, and the potential of our solutions to create a meaningful impact made joining the programme a no-brainer.

After the completion of the immersion phase, our focus will shift to solution creation and commercial development, where needs identified in-clinic are developed into refined solutions and prototypes.

Although my background in technology research and development appears better suited to the latter stages of the programme, the boot camp stage has me feeling ready to get started.

I feel prepared, but also a little apprehensive. I understand the expectations of a fellow on the programme, but I have no idea what I am going to experience.

What am I going to see? How will I be received by patients? What is it like observing a birth? Will I uncover any unmet needs? Will they be any good?

Time, as we have been told on many occasions so far, to lean into the process.

There is no ‘I’ in teamwork

Our new team is here announcing our team name “Innopatient” at an online event for all fellows. To the left is Christoffer Rinder Larsen, in the middle is Thorkil Anker-Møller and to the right it’s me, Catharina Holland.

On the first day of the team announcement seminar in November, you could feel the excitement flow from all the fellows. It was almost like waiting for Christmas Eve. At this point in the program, we were well into the clinical immersion and had gotten to know each other. My general feeling was that it didn’t really matter who you were placed in a team with, because all teams would be great. Nonetheless, as the time came near for the team announcement, I just really wanted to know.

Foto: The picture on the right shows the Aarhus fellows visiting the pediatric department at Aalborg University Hospital for the first time.

Teambuilding kicked us off

One of the teambuilding exercises was to make a specific figure in the shortest time possible.

The teams were announced at a seminar, which also provided the framework for getting to know your teammates and how you collaborate. I was pleasantly surprised by how the teambuilding activities made it clear to us how we worked as a team and which pitfalls we should look out for. 

Following the teambuilding activities, our first job was to fill out our team mission. This forced us to quickly discuss up front what we saw as the strengths and weaknesses of our new team. It also made the foundation for creating a safe space to discuss insecurities and doubts. At the end of the team announcement seminar, we were filled up with positive energy and knowledge about what we would expect going forward in the program as teams, and we were eager to get started.

New week, new demands.

My team counts three team members, all with different backgrounds. I’m a biomedical engineer myself, Thorkild is a medical doctor and Christoffer is a physiotherapist and a health tech consultant. Naturally we have different ways of thinking, which I see as a big strength. However, being a team member also means being well aligned with your teammates, figuring out how to share knowledge and observations between each other and last but not least how to settle on the needs you want to bring forward into the creative skills phase.

Our team having a moment of reflection on action – a serious moment.

Not left to our own devices

Throughout the program there are scheduled mentor sessions for each team and mid-December was our first session. The team mentor is mainly there to guide us through the ups and downs. For our first session we talked about why we were put in a team together, and it made a lot of sense going over what we had in common and where we would complement each other. Getting personal feedback on that level can be daunting, but it is definitely a great opportunity to help you get to know yourself better both individually and in the team constellation.

It is not all fun and games, or is it?

In a couple of days, the Christmas holidays are upon us, and we as a team have met our first major deadline of handing in our need specification documents. It has been hard, but great teamwork does make the work more fun. I’m definitely looking forward to learning more and to enter the creative skills phase with my team. I’m sure it is going to be both interesting and a lot of fun.

“It is a new model we want to see expand to all of the Nordics”

Need some answers?

Webinar about the BioMedical Design Programme

Webinar about the BMD programme with managing director Sys Zoffmann Glud and fellows Lene Ladegaard and Kasper Linde from the 2019/2020 cohort.

If you have unanswered questions about the BioMedical Design Novo Nordisk Foundation Fellowship Programme then you should watch this webinar. It can tell you more about the learning process and some examples of why people have applied, and what they think about the learning process.

New BMD teams observing ears, noses and throats – stomachs and kidneys

– BioMedical Design fellows doing their clinical immersion on otolaryngology, gastroenterology and nephrology

The new classes of BioMedical Design fellows got together at the old Skjoldnæsholm Castle on Zealand to mark the transition from boot camp to clinical immersion. At the meet up fellows learned their clinical focus area and their team mates for the next nine months. During Clinical immersion fellows will observe clinical staff to spot important needs in a specific hospital ward. The goal is to help solve needs by developing new devices and technology.

The two Aarhus teams are both concentrating their needs-finding in the ear, nose and throat (ENT) surgery department at Aarhus University Hospital. Teams (and their tentative names) are:
Team Prominens: Kasper Linde Christensen, Naja Villadsen, Christian Friis and Jasper Nijkamp

Team invENT: Martin Knudsen, Chantelle Driever, Lene Ladegaard Larsen and Sebastian Udholm
Department of Otorhinolaryngology, or ear, nose and throat (ENT) covers a broad spectrum of diseases such as hearing loss, tinnitus, dizziness, facial nerve disordes as well as infections and cancer in the ear, nose and throat area.

The Copenhagen teams are (also by working titles):

Team Renaid: Nina Puch Ørnskov, Staffan Holmberg-Thydén, Roeen Roashan and Louise Engel Balling. They will be observing at the Nephrology Clinic at Rigshospitalet where experts work to prevent and treat kidney failure.

Reactions on the new medical focus
Nina Puch Ørnskov, previously an anesthesia nurse, was happy about her new clinical area.
“Nephrology is interesting to me because of all the rather complicated machines used for dialysis. It’s great to look at something this complex with fresh eyes.”
Roeen Roashan, whose background is business and as a senior analyst, originally had a preference for gastroenterology. After learning the nephrology focus, he says:
“I’m happy to go to nephrology. When I look at the heavy problems connected to the patient experience I think we can work with the patient’s quality of life. I think we can find a window for incremental and radical innovation.”

The Green Team: Marie Parslov, Cecilie Ammitzbøll, Chris Gibbs and Rastislav Monosik observing at the Surgical Gastroenterology Department at Rigshospitalet, specialized in (among others) cancer in the upper gastrointestinal tract and late complications from stomach surgery.

More tech solutions awaits
Copenhagen fellow Rastislav Monosik from the Green Team has a background in food chemistry and technology. He is one of four men in the Copenhagen group that consists of one engineer, one holds an MBA, two doctors, one industrial designer, one anesthesia nurse and one nurse who also holds a degree in IT-development.
“I was very happy to go to an area with a lot of technological tools and some robotic solutions. I like the combination of the human factor and tech, and establishing synergy between them. In a near future I think manual labor will be replaced by technology and robots to a much larger extent, including at the hospitals.”

Strong need for innovation
Consulting surgeon at the Surgical Gastroenterology Clinic at Rigshospitalet, Michael Achiam, is thrilled to have the four fellows of the Green Team innovating at ‘his’ ward.
“We experience an explosion in the rise of patients, and our recourses haven’t changed accordingly. But even if our time is scarce we love to have the fellows here, because we need innovation to optimize our working processes to fit the new standards.”

Welcoming Speech by Sys Zoffmann Glud

BioMedical Design Inauguration Day

September 2nd 2019

At Biomedical Design we want to empower talents in need led health innovation. We do that with the intention of supplying Danish healthcare, Danish research institutions and the Danish health tech industry with innovation leaders who come with a more holistic view of all what it takes. From identifying a problem to putting a solution in front of the user. It is a complex field to navigate in, and that is why we see there is a need for people who understand the whole process, who know how to reach out to the right people at the right moments of the process, to get the right help.

Meaningful Innovation that Matters
We want to have more innovation leaders in health care, because innovation matters to people. It really impacts peoples’ quality of life that we make good innovation, specially people who get sick or disabled. That’s why we should do it well. We should make meaningful innovation which matters to people.

A Push Back from Health Care Payers
However, we need to be careful about the approach we take, when we innovate. And right now I would say the value chain of innovating for health care is about to be broken. Historically it has been a very technology driven process where health care payers happily paid what it cost to take in all the innovation that companies developed. But now we see that there is a push back from the health care payers. They simply can’t afford all the good ideas and good solutions coming from the industry.

New Health Innovators are Needed
We need people who can approach the innovation of health care from a new perspective and yet make it beneficial for all parties in the value chain. We believe that the BioMedical Design Programme is one of the answers to this this dilemma. That’s why we have put together a ten months full time fellowship program in which we today enroll 16 very talented people who are skilled in each their domain, and during the next ten months will become skilled health innovators too.

The Boot Camp
The first month is a boot camp where we’ll give the fellows a basic introduction to the different clinical fields they’ll enter. To do observations and find problems. We’ll teach them health ethnography. Teach them small introductions to design thinking, something they’ll work with more deeply later. They’ll get to know each other and after the first month they will be put in teams of four with whom they’ll be together for the rest of the fellowship. They might not like their team mates all the time throughout these ten months. But that is also a part of the learning process. You have to learn to navigate and solve team issues.

Clinical Immersion
Then they’ll be immersed into different clinical fields. Two teams will have their base at Rigshospitalet in Surgical Gastroenterology and Nephrology and here in Aarhus the fellows will do their Clinical Immersion in the Ears-Nose-and-Throat department (Otolaryngology). In this process they will identify innumerable problems. Small problems, local problems but also some needs which have not been identified before. Not even by the staff working there. During four weeks they will be exploring widely, and then they will go through a process to narrow them down to 12 needs and validate these.

Big Impact Required
Validation means, that fellows have to go out and interview people in the clinic and ask: “Have I understood this clinical need?”, “Do you agree that it exists?”, and go out and see if they can retrieve the same situation in other hospital settings in Denmark and abroad. That is all sort of the qualitative identification of needs. Then they have to support in a more quantitative manner – digging down into literature and databases, looking for numbers which can support that there is a true problem and where there is a possibility to create a big impact even though fellows don’t know, what could be the solution yet.

Creative Skills
Innovation is not happening without getting good ideas. For some people it is easy to get good ideas and for others it is difficult – but this is a skill you can learn and that’s why we are working with it in the creative skills phase. Training the ability to come up with great ideas and to build on the ideas of others. To build on ideas that are out there in the world already, but improving them – and help solve issues that previous ideas haven’t solved.

In that process they will generate many ideas and again these ideas have to be validated if they are the right type of solution to the right need. It will be a challenging process because fellows will experience lots of insecurity. There are heaps of questions popping up. “Can it technically be done?”, “Has somebody already gotten this idea and patented it?”. “Damn, yes!” – and you have to go back to another solution. It’s a back and forth process, but the fellows are actually quite lucky, because while they are at this program they can work on multiple ideas at the same time. It’s a horse race – but they don’t need to go that far back to pick up another need and another solution – for sure they will end up with something.

Commercial Skills
Finally, we have the Commercial Skills phase. At this point fellows have two great ideas, and they quickly have to figure out which one can be developed further and have a sound business model built around it. They have to ask themselves, which idea is the most feasible for us with the competences we have in our own team and in our network to continue with? It will be a very intense process. Fellows will have to develop their commercial skills on the one side and parallel to that they will have to work on prototyping their solution so they stand with a fairly good prototype at the end of the program.

What Then?
Fellows will be there with an idea and they know quite a bit about the marked. We will let it up to some of all the other Danish institutions like funds and investors we have, to bring the fellows further on with their projects. This counts for those fellows who want to continue with their projects. Because it’s not the sole goal of this program to create start-ups and start-up teams. It’s our hope that many will – but the purpose is also to get the competences they have achieved out in the broader innovation ecosystem in Denmark because there are so many angles from which you can do good innovation.