Incredible facts
Human health directly concerns each of us.
The media is replete with stories about our health and body, from the creation of new drugs to the discovery of unique surgical techniques that give hope to people with disabilities.
Below we will talk about the latest achievements modern medicine.
10. Scientists have identified a new body part
Back in 1879, a French surgeon named Paul Segond described in one of his studies the “pearly, resistant fibrous tissue” running along the ligaments in the human knee.
This study was conveniently forgotten until 2013, when scientists discovered the anterolateral ligament, knee ligament , which is often damaged when injuries and other problems occur.
Considering how often a person's knee is scanned, the discovery came very late. It is described in the journal Anatomy and published online in August 2013.
9. Brain-computer interface
Scientists working at Korea University and the German University of Technology have developed a new interface that allows the user control the exoskeleton of the lower extremities.
It works by decoding specific brain signals. The results of the study were published in August 2015 in the journal Neural Engineering.
Participants in the experiment wore an electroencephalogram headgear and controlled the exoskeleton by simply looking at one of five LEDs mounted on the interface. This caused the exoskeleton to move forward, turn right or left, and sit or stand.
So far the system has only been tested on healthy volunteers, but it is hoped that it could eventually be used to help people with disabilities.
Study co-author Klaus Muller explained that “people with lateral amyotrophic sclerosis or with spinal cord injuries often have difficulty communicating and controlling their limbs; deciphering their brain signals with such a system offers a solution to both problems."
8. A device that can move a paralyzed limb with the power of thought
In 2010, Ian Burkhart was left paralyzed when he broke his neck in a swimming pool accident. In 2013, thanks to the joint efforts of specialists from Ohio State University and Battelle, a man became the first person in the world who can now bypass his spinal cord and move a limb using only the power of thought.
The breakthrough came thanks to the use of a new type of electronic nerve bypass, a pea-sized device that implanted in the motor cortex of the human brain.
The chip interprets brain signals and transmits them to the computer. The computer reads the signals and sends them to a special sleeve worn by the patient. Thus, the right muscles are put into action.
The whole process takes a split second. However, to achieve such a result, the team had to work hard. The team of technologists first figured out the exact sequence of electrodes that allowed Burkhart to move his arm.
Then the man had to undergo several months of therapy to restore atrophied muscles. The end result is that he is now can rotate his hand, clench it into a fist, and also determine by touch what is in front of him.
7. A bacterium that feeds on nicotine and helps smokers quit the habit.
Quitting smoking is an extremely difficult task. Anyone who has tried to do this will confirm what was said. Almost 80 percent of those who tried to do this using pharmaceutical drugs, failed.
In 2015, scientists from the Scripps Research Institute are giving new hope to those who want to quit. They were able to identify a bacterial enzyme that eats nicotine before it can reach the brain.
The enzyme belongs to the bacterium Pseudomonas putida. This enzyme is not a new discovery, however, it has only recently been developed in the laboratory.
Researchers plan to use this enzyme to create new methods of quitting smoking. By blocking nicotine before it reaches the brain and triggers dopamine production, they hope they can discourage smokers from putting their mouths on a cigarette.
To be effective, any therapy must be sufficiently stable, without causing additional problems during activity. Currently a laboratory-produced enzyme behaves stably for more than three weeks while in a buffer solution.
Tests involving laboratory mice showed no side effects. The scientists published the results of their research in the online version of the August issue of the journal American Chemical Society.
6. Universal flu vaccine
Peptides are short chains of amino acids that exist in the cellular structure. They act as the main building block for proteins. In 2012, scientists working at the University of Southampton, the University of Oxford and the Retroskin Virology Laboratory, succeeded in identifying a new set of peptides found in the influenza virus.
This could lead to the creation of a universal vaccine against all strains of the virus. The results were published in the journal Nature Medicine.
In the case of influenza, the peptides on the outer surface of the virus mutate very quickly, making them almost inaccessible to vaccines and drugs. The newly discovered peptides live in the internal structure of the cell and mutate quite slowly.
Moreover, these internal structures can be found in every strain of influenza, from classical to avian. The current flu vaccine takes about six months to develop, but does not provide long-term immunity.
However, it is possible, by focusing efforts on the work of internal peptides, to create a universal vaccine that will give long-term protection.
Flu is viral disease upper respiratory tract, which affects the nose, throat and lungs. It can be deadly, especially if a child or elderly person becomes infected.
Influenza strains have been responsible for several pandemics throughout history, the worst of which was the 1918 pandemic. No one knows for sure how many people have died from the disease, but some estimates suggest 30-50 million people worldwide.
5. Possible treatment for Parkinson's disease
In 2014, scientists took artificial but fully functioning human neurons and successfully grafted them into the brains of mice. Neurons have the potential to treating and even curing diseases such as Parkinson's disease.
The neurons were created by a team of specialists from the Max Planck Institute, the University Hospital Münster and the University of Bielefeld. Scientists managed to create stable nerve tissue from neurons reprogrammed from skin cells.
In other words, they induced neural stem cells. This is a method that increases the compatibility of new neurons. After six months, the mice did not develop any side effects, and the implanted neurons integrated perfectly with their brains.
The rodents showed normal brain activity, resulting in the formation of new synapses.
The new technique has the potential to give neuroscientists the ability to replace diseased, damaged neurons with healthy cells that could one day fight Parkinson's disease. Because of it, the neurons that supply dopamine die.
There is currently no cure for this disease, but the symptoms are treatable. The disease usually develops in people aged 50-60 years. At the same time, the muscles become stiff, changes occur in speech, gait changes and tremors appear.
4. The world's first bionic eye
Retinitis pigmentosa is the most common hereditary diseases eye. It leads to partial loss of vision, and often to complete blindness. Early symptoms include loss of night vision and difficulty with peripheral vision.
In 2013, the Argus II retinal prosthetic system was created, the world's first bionic eye designed to treat advanced retinitis pigmentosa.
The Argus II system is a pair of external glasses equipped with a camera. The images are converted into electrical impulses that are transmitted to electrodes implanted in the patient's retina.
These images are perceived by the brain as light patterns. The person learns to interpret these patterns, gradually restoring visual perception.
Currently, the Argus II system is only available in the United States and Canada, but there are plans to implement it worldwide.
3. Painkiller that works only due to light
Severe pain is traditionally treated with opioid medications. The main disadvantage is that many of these drugs can be addictive, so their potential for abuse is enormous.
What if scientists could stop pain using nothing but light?
In April 2015, neurologists at Washington University School of Medicine in St. Louis announced that they had succeeded.
By combining a light-sensitive protein with opioid receptors in a test tube, they were able to activate opioid receptors the same way opiates do, but only with light.
It is hoped that experts can develop ways to use light to relieve pain while using drugs with fewer side effects. According to research by Edward R. Siuda, it is likely that with more experimentation, light could completely replace drugs.
To test the new receptor, an LED chip about the size of a human hair was implanted into the brain of a mouse, which was then linked to the receptor. Mice were placed in a chamber where their receptors were stimulated to produce dopamine.
If the mice left the special designated area, the lights were turned off and the stimulation stopped. The rodents quickly returned to their place.
2. Artificial ribosomes
A ribosome is a molecular machine made up of two subunits that use amino acids from cells to make proteins.
Each of the ribosomal subunits is synthesized in the cell nucleus and then exported to the cytoplasm.
In 2015, researchers Alexander Mankin and Michael Jewett were able to create the world's first artificial ribosome. Thanks to this, humanity has a chance to learn new details about the operation of this molecular machine.
Science always amazes with its new discoveries, turning things that one could only dream of into real working inventions, which we, in turn, often take for granted in a world of frantic rhythm. Especially, which is developing at such a speed that some of the same things we are used to seeing in science fiction films will soon find their way into the healthcare system. All of these innovations have the potential to change the face of the healthcare industry and the lives of millions of people.
From human head transplants and cancer traps to new treatments for depression, these medical changes will become a reality in 2017. If some of the innovations seem crazy, remember that once upon a time video communications, smartphones and space travel were only on the pages of science fiction books.
Many departments and health insurance companies around the world are under enormous pressure for many years now. Some of them are already close to closing due to a pointlessly complicated system. As a result, patients experience excruciating delays when it comes to paying medical bills or making routine doctor appointments.
Thanks to the BZSR, the health care system will function much more easily. BCSR will act as a translator between the two systems medical care. This will help streamline the clinical data return process. Why is this so revolutionary? Because more life-saving data can be shared across departments, meaning more lives will be saved. more lives. You may be interested in the article 10 myths about homeopathy.
Smartwatches can track your fitness levels and help you stay fit. But what about technology that you can carry with you everywhere and that can also save your life? In 2013, a team of Swiss biologists developed an implantable device that could monitor substances in the blood and send this data to a phone. Researchers hope that the device will be ready for sale by 2017.
The device is 14 mm long and its surface is partially coated with an enzyme that can detect such chemical elements like glucose and lactate. Essentially, this thing can track in real time and may be able to warn a patient of a heart attack hours in advance. Despite the fact that the device is at the development stage, the potential of this mini-laboratory is amazing.
If the idea of driverless cars is scary, think about the horrific statistics involving cars with a driver at the steering wheel. More than 38,000 car accidents each year result in death or disability.
Fortunately, car safety getting smarter every day. Whether there will be driverless cars or not, one thing is certain - your four-wheeled friend will take care of your safety. Automatic features like collision warning sensors, softer cruise control and anti-sleep devices will find their way into cars released in 2017. Slowly but surely, safety technology is aiming to remove the human element from driving.
By 2017, rotting and falling teeth can be regenerated. A team of Japanese cytologists at the University of Tokyo has demonstrated tooth regeneration in mice, and they now believe that with further research, this technology could be made available to humans.
Using a combination of stem cells and specific dental germs from mouse embryos, the team successfully grew a new tooth in a mouse's jaw in 36 days, complete with roots, pulp and outer layer of enamel - just like a real one! Once the procedure is available, it will cost a considerable amount of money.
The gastrointestinal tract is home to trillions of bacteria that create a community called the microbiome. What's both scary and great here is that these germs can release chemicals into the body that interfere with food digestion, response to medications, or help spread disease.
For decades, diabetes has been a major problem. People with diabetes are twice as likely to have heart disease or suffer a stroke than those who don't. However, thanks to medications, patients have a better chance of living a long, healthy life with diabetes.
Typically, to find cancer cells in the body, a biopsy is used, which involves collecting large quantity patient tissue. Fortunately, a less painful and expensive form of biopsy is on the way. A liquid biopsy is a blood test that will show signs of cancerous DNA.
This incredible leap means that cancer could soon be detected through cerebrospinal fluid, body fluids, and even urine. New tests will be carried out in next year. With advances like these, it's not that hard to imagine a world without cancer.
Chimeric antigen receptor– a form of cellular immunotherapy. It represents an incredible breakthrough for leukemia patients. The therapy involves removing T cells and genetically altering them to target and destroy cancer cells.
Once the cancer cells are destroyed, the T cells remain in the body to prevent recurrence. This unique treatment could end chemotherapy in the future and may even be able to cure late stages leukemia.
600,000 patients have metal stents implanted to treat blockages coronary artery. Once the artery has widened, the stents remain in the body forever. In rare cases, they can cause blood clots, ironically defeating the whole purpose of the stent itself.
Fortunately, a new self-dissolving stent will allow patients to rely less on medications for blockages. This new stent is made from a naturally dissolving polymer. It dilates arteries like regular stents, but remains in the body for two years before being absorbed internally.
Even in 2016, we don't know much about depression and the various effects it has on people, making it an even more severe illness. A third of patients do not respond to traditional medications due to lack of research and development, costing lives.
However, a ray of hope exists in the form of ketamine. Formerly known as " party A drug, ketamine contains properties that are aimed at inhibiting NMDA receptors in nerve cells. These receptors are extremely responsive to symptoms of depression. Studies have already shown that 70% of patients with drug-resistant depression noticed improvements in symptoms after 24 hours.
Such successful effects of ketamine on patients have already prompted the development of other drugs targeting NMDA to increase the availability of more effective treatments for depression in 2017.
HPV is responsible for 99% of cervical cancer cases. And the worrying thing here is that many women around the world may be at risk of dying from cervical cancer even without being diagnosed.
Currently, HPV prevention and treatment is limited to women with access to HPV testing and vaccines, leaving women completely in the dark when it comes to detection dangerous virus. Fortunately, scientists plan to increase peace of mind for women in 2017. Self-testing for HPV will allow patients to send samples to a laboratory.
Surgery is incredibly complex at the best of times, but for eye surgeons and neurosurgeons it is even more difficult because they are timed to the minute. In these cases, attention to detail is a matter of life and death. Many surgeons must perform jewelry work for hours with their heads bowed and looking through a microscope, which puts constant strain on their back and neck.
This approach to work is not productive for both the surgeon and the patient. This is why new 3D cameras have been developed. They assist surgeons and their colleagues during complex operations. These 3D cameras create holographic anatomical aids that allow surgeons to work more comfortably. Rishi Singh, a surgeon at the Cleveland Institute of Eye Microsurgery, has been working with the new technology for 6 months. He notes that this widens the field of view and provides greater comfort. Knowing that the surgeon is comfortable, the patient himself will feel more confident.
Between 1983 (when HIV was first described) and 2010, the HIV/AIDS virus claimed the lives of more than 35 million people around the world. Many people are living with this virus. A working HIV vaccine is seen as the holy grail. Extensive testing of the vaccine, which appeared in 2012, is fortunately leading ever closer to this very holy grail.
The 2012 vaccine, known as SAV001, was successfully tested in experimental animals and has now entered the human testing phase in Canada. The vaccine was administered to women and men from 18 to 50 with positive results. Patients did not experience any side effects or reactions to the injections and even showed an increase in immunity. The vaccine had positive results on phases 2 and 3. It is hoped that it will be commercially available in 2017.
Prostate cancer is the second leading cause of male cancer-related death in men over 50. What makes prostate cancer deadly is that it spreads very quickly to other parts of the body, including the bones and lymph nodes.
Fortunately, survival rates from prostate cancer are increasing, thanks to new effective forms treatment. FUVI was used in a 2012 study in which cancer cells were killed and 95% of participants were cured after 12 months. FUVI targets cancer cells the size of a grain of rice and heats them to 80-90 degrees. This effectively kills cancer cells in one area without damaging healthy tissue nearby.
Since then, more testing has been carried out with similar successful results. The treatment is set to be offered worldwide in 2017, potentially saving the lives of thousands of men every year.
You have heard about hair and face transplantation. Now an ambitious Italian surgeon wants to attempt the first human head transplant. Sergio Canavero even has a volunteer for the incredibly risky and complex procedure, 31-year-old Russian man Valery Spiridonov, who suffers from muscular dystrophy and has been wheelchair-bound his entire life.
The record-breaking operation will take place in December 2017. The procedure will involve 150 medical personnel and will take about 36 hours, during which the donor's head and body will be frozen to -15 degrees to prevent cell death.
Because of poor condition life and limited life expectancy, Spiridonov considers the risk justified. Let's hope Dr. Canavero can pull this off... (and put everything back together correctly).
Medicine is developing at a tremendous speed, and many of the things we saw in science fiction films have become a reality in the healthcare system today. Most of these innovations have the potential to improve the quality of life for millions of people
1. Health insurance companies and departments are under enormous pressure from a complex system, which sometimes leads to their closure. As a result, many patients face long waits for medical bills to be paid or for doctor's appointments. In 2017, the Interoperable Resource Rapid Health System (RCHS) was introduced and will function much more easily. The new system acts as a translator between the two health care systems and simplifies the process of returning clinical data. This method is considered revolutionary as a large amount of life-saving data can be used by different departments.
2. A convenient and useful invention this year is wireless health monitoring using electronic gadgets, such as smart watches, which can track the level of physical fitness and help maintain it. In addition, back in 2013, Swiss biologists developed an implantable device capable of monitoring substances in the blood and sending data to the phone. The 14mm device is scheduled to go on sale this year. The surface of the device is coated with an enzyme that can detect glucose and lactate. A smart phone will be able to track a person's health in real time and warn of a heart attack several hours in advance.
3. In the field of dentistry, there is a proposal to regenerate falling teeth. Thus, a group of scientists from the University of Tokyo regenerated mouse teeth and proposes to use the technology for humans. The new tooth was grown into the jaw over 36 days using a combination of stem cells and mouse embryonic tooth germs. As a result, scientists received a real tooth with roots, pulp and an outer layer of enamel.
4. B recent years researchers and biotech companies are working to change the behavior of microbes gastrointestinal tract and direct them to fight for human health, and not against it. The development of new diagnostics and products with prebiotics will prevent dangerous microbial imbalances as early as 2017.
Medicine has advanced in the treatment of a complex disease – depression. Scientists have found a solution in the form of ketamine, also known as the party drug.
Ketamine has properties aimed at inhibiting NMDA receptors in nerve cells that are highly responsive to symptoms of depression.
5. A step forward in innovative medicine - the invention of new drugs for diabetes to reduce the risk of heart disease, which has been a major problem for decades. It is known that people with diabetes are twice as likely to suffer from heart disease and stroke. Thanks to new drugs - Empagliflozin and Liraglutide - many patients have a chance to live a long life with diabetes. Drug studies have shown a reduction in heart-related complications and deaths. In 2017, major advances in diabetes treatment are planned.
6. In addition, doctors have developed a liquid biopsy that can diagnose cancer. This is usually done using a method that involves collecting a large amount of tissue from the patient. However, a less painful and cheaper version is now on the way. A blood test can look for signs of cancerous DNA, allowing cancer to be detected through spinal fluid, body fluids and even urine. Testing will start at the end of 2017.
7. Chimeric antigen receptor therapy is now available for leukemia patients, which involves removing T cells and genetically altering them to find and remove cancer cells. Once the cells are destroyed, the T lymphocytes remain in the body to prevent recurrence of the disease. This treatment could end chemotherapy and allow the most advanced stages of leukemia to be treated.
To treat a blocked coronary artery, a new self-dissolving stent has been developed that will not remain in the patient's body or cause blood clots. The new stent allows for the expansion of arteries and will be made of a naturally dissolving polymer.
8. This year, medicine has advanced in the treatment of a complex disease - depression. Scientists have found a solution in the form of ketamine, also known as the party drug. Ketamine has properties aimed at inhibiting NMDA receptors in nerve cells that are highly responsive to symptoms of depression. According to studies, 70% of patients with a persistent drug reaction after using ketamine noticed an improvement within 24 hours.
9. Vaccine against terrible disease HIV, which began testing in 2012, has been successfully tested in animals and is now being tested in humans in Canada. With positive results, the vaccine was administered to women and men aged 18 to 50 years, and patients did not experience any side effects or reactions to the injections. The vaccine is planned to be commercially available this year.
The volunteer for such a risky procedure will be 31-year-old Russian Valery Spiridonov, who suffers from muscular dystrophy and is confined to a wheelchair. The procedure will involve 150 people and will last about 36 hours.
10. The most shocking innovation of 2017 was human head transplantation, which Italian surgeon Sergio Canavero is preparing for in December 2017. The volunteer for such a risky procedure will be 31-year-old Russian Valery Spiridonov, who suffers from muscular dystrophy and is confined to a wheelchair. The procedure will involve 150 people and will last about 36 hours. To prevent cell death during surgery, the donor's head and body will be frozen to -15 degrees. The patient himself, due to his limited life expectancy, considers this risk to be completely justified.
Medicine is developing very quickly, and advances in the field medical science and technology has significantly changed our lives. Scientific research, high-tech equipment and innovative devices have made possible many of the things that seemed impossible just recently. We have compiled for you a list of the 10 latest medical technologies that will help improve the health of humanity in 2017.
Use of intestinal bacteria for the prevention, diagnosis and treatment of diseases. The bacteria in our bodies—and the compounds they release—impact how food is digested and the development of certain diseases. Biotech companies that once focused on the genome are now actively exploring the potential of the gut microbiome, developing new methods of using probiotics to prevent health-threatening gut imbalances.
Half of patients with type 2 diabetes die from complications associated with cardiovascular disease. But now, thanks to new drugs, the chances of diabetics surviving to their 65th birthday have increased by 70%. These drugs reduce the progression of heart disease, providing a complex effect on many organs. Given these positive results, experts predict significant changes in medications prescribed for people with diabetes, as well as a wave of new research focused on type 2 diabetes and its related diseases.
Scientists have developed a cellular immunotherapy in which a patient's immune T cells are removed and genetically reprogrammed to seek out and destroy cancer cells. This innovative treatment method has shown impressive results in the treatment of leukemia and non-Hodgkin's lymphoma. It is believed that cellular immunotherapy could one day replace chemotherapy and save thousands of lives without side effects.
The test, known as a “liquid biopsy,” can detect signs of circulating tumor DNA, which is found in the bloodstream in 100 times more quantities than tumor cells themselves. “Liquid biopsy” is touted as a leading technology for cancer diagnosis, and while research is still ongoing, this revolutionary test is projected to generate $10 billion in annual sales. Some pharmaceutical companies testing kits are already being developed to bring them to market as soon as possible.
Automobile accidents remain a leading cause of death and disability, not to mention significant expense. New automated safety features promise to significantly reduce the number of dangerous road accidents. These features range from pre-collision systems to adaptive cruise control.
IN modern world medical workers It is becoming increasingly difficult to share patient data effectively and securely. Information technologies have become so diverse that today it is increasingly difficult for doctors to communicate with each other. To solve this problem, scientists have developed a new tool - FHIR (Fast Healthcare Interoperability Resources) - which will act as intermediaries between the two healthcare systems, allowing the transfer of clinical data and billing.
Scientists are currently testing Ketamine, a drug commonly used for anesthesia, for its ability to suppress depressive disorders. The results were overwhelmingly favorable, demonstrating that 70% of patients with treatment-resistant depression experienced a significant reduction in symptoms within 24 hours of receiving Ketamine. Such rapid treatment of severe depression is extremely important, doctors say, since depression is serious problem health care and often leads to suicide. It is likely that in the future Ketamine will be available to treat patients suffering from depressive disorders.
Surgeons typically rely on special cameras to help them perform operations. However, the outcome of the work and the ability to perform the most precise tasks also tend to depend on the physician's own eyes and interpretation of the information received. However, a person's peripheral vision is limited, and the muscles of the back and neck are tense during work. To solve this problem, scientists began experimenting with 3D visualization and augmented reality technology, which combines the real and virtual worlds. Developed stereoscopic systems can create visual templates for surgeons to help them perform specific tasks. It is noted that this technology provides additional comfort and enables surgeons to work more efficiently. Several hospitals plan to test these virtual reality tools in 2017.
Most sexually active women have human papillomavirus (HPV). According to statistics, certain strains of HPV are responsible for 99% of cervical cancer cases. Despite great advances in HPV prevention and treatment, few women have access to HPV tests and vaccines. To expand this access, scientists have developed a self-administered HPV test kit that includes a tube and swab. Women can send a sample to a laboratory and receive an alert about the presence of dangerous strains of HPV.
Each year, 600,000 people undergo surgery to install metal stents to treat a blocked coronary artery. The stent remains in the body forever and can cause other complications in the future. To prevent this from happening, scientists have developed the world's first bioresorbable stent. It is made from a natural polymer and dilates a clogged artery for two years before dissolving like dissolvable sutures.
© Design. Publishing house High school Economics, 2013
All rights reserved. No part of the electronic version of this book may be reproduced in any form or by any means, including posting on the Internet or corporate networks, for private or public use without the written permission of the copyright owner.
Zasimova Lyudmila Sergeevna– Candidate of Economic Sciences, Associate Professor at the National Research University Higher School of Economics.
Kadyrov Farit Nakipovich– Doctor of Economics, Deputy Director of the Central Research Institute of Organization and Informatization of Health Care of the Ministry of Health of the Russian Federation, Professor of the National Research University Higher School of Economics.
Salakhutdinova Sevil Kamalovna– Candidate of Economic Sciences, Health Specialist, World Bank.
Chernets Vladimir Alekseevich– Healthcare management consultant.
Shishkin Sergey Vladimirovich– Doctor of Economic Sciences, scientific supervisor Institute of Health Economics, National Research University Higher School of Economics.
WHO – World Health Organization
VMP – high-tech medical care
VHI – voluntary medical insurance
EU – European Community
IR - research and development
MOUZ - municipal health authorities
Health care facility – medical and preventive institution
NHS – UK National Health Service
HTA – Health Technology Assessment
Compulsory medical insurance - compulsory health insurance
OECD – Organization for Economic Co-operation and Development
Software – software
ROZE – regional health authorities
Central district hospital - central district hospital
PPP – public-private partnership
NICE – National Institute for Health and Clinical Excellence (National Institute for Health and Clinical Excellence)
The future of healthcare depends critically on the nature and pace of change in medical technology. Throughout the twentieth century. technological discoveries have brought significant changes to medicine. Their role is obvious: new technologies for prevention, diagnosis and treatment make it possible to avoid surgical intervention, shorten the recovery period, reduce risks undesirable consequences treatment, etc.
Introducing new technologies in healthcare organizations usually means purchasing new equipment. Global medical device costs are rising despite efforts in developed countries to curb government spending on health care. The global market for medical technology and equipment in 2010 was estimated at $326.8 billion, and is projected to reach $370.7 billion by 2015. New technologies are implemented in more expensive equipment. The increase in costs will also be due to the presence of a significant amount of new technologies in related industries - primarily information, telecommunications, bio- and nanotechnologies, genetic engineering, etc.
The medical equipment market in Russia as of 2010, according to various estimates, ranged from 100 to 110 billion rubles. According to expert forecasts, its growth for the period 2010–2020. may reach 13.4% in real terms, and its volume in nominal terms in 2020 may reach 450 billion rubles. [Ministry of Industry and Trade, 2011]. The main growth factors, in addition to the increasing complexity and cost of new medical technologies, will be the implementation of the State Program “Healthcare Development in the Russian Federation in 2013–2020”, which includes an impressive investment component, regional programs in the field of health care, as well as the development of the private sector in health care, responding to growing middle class demand for quality medical services.
The rapid development of medical and information technologies poses a serious challenge to the healthcare system. New technologies open up the possibility of radically increasing efficiency in identifying individual risk factors for diseases, their early diagnosis, reducing the volume of inpatient care due to the development of minimally invasive, outpatient surgery, telemedicine, and remote monitoring of the patient’s condition. The introduction of new technologies will stimulate structural changes in the delivery system medical care, increasing population needs for new medical services and at the same time increasing expectations regarding the state’s provision of their availability.
It is obvious that increasing the volume of investment in new technologies and equipment does not automatically mean an increase in the availability and quality of medical care, corresponding to the rate of growth of costs. The clinical and economic effectiveness of new investments will be determined not only by the price and clinical effectiveness of the new medical equipment, but also to a large extent - by the institutional conditions for the introduction of new technologies into practice. We are talking about organizing decision-making on updating the equipment of medical institutions, as well as mechanisms for financing such costs and purchasing new equipment.
Today, the renovation of medical equipment in Russian medical institutions is attracting increased public attention. There are known scandals involving the purchase by regional and municipal authorities of computed tomographs and other expensive medical equipment at inflated prices, untimely deliveries, miscalculations in the selection of equipment, etc. Government purchases of new equipment within the framework of the National Health Project were accompanied by inadequate consideration of the needs of medical institutions in new technology, their capabilities to provide efficient use new sophisticated equipment.
It should be noted that many aspects of state policy in the field of introduction of new technologies have been sufficiently studied by foreign researchers. The literature describes models of decision-making about innovation at the health care facility level and the factors that promote or hinder innovation in medicine, as well as the role of health technology assessments (HTA) in the decision-making process for their implementation. In Russia, this issue has been studied much less well. There are separate works devoted to the effectiveness of information technologies in medicine, the problems of implementing HTA procedures, and organizational obstacles to the introduction of new technologies (see, for example, the works of V.V. Vlasov, F.N. Kadyrov). But research in general is fragmentary. There have been no attempts to give a holistic picture of the institutional conditions for the introduction of new medical technologies in our country.
What are the interests of decision-making subjects on the introduction of new technologies in medical institutions? How is the decision-making process on the introduction of new technologies organized and different in medical organizations of different types and forms of ownership? In what situations is the implementation of new technologies successful? These and many other questions are not answered in studies devoted to Russia.
Taking into account all the noted circumstances, the relevance of studying the existing models of technological innovation in medical organizations that have developed in our country, the feasibility and possibility of changing them, is obvious. This study was conducted during 2009–2011. within the program basic research National Research University Higher School of Economics.
The subject of the study was the organizational and economic mechanisms for introducing new medical technologies in medical organizations.
The study was focused on solving the following problems.
Firstly, an analysis of theoretical works devoted to decision-making on the introduction of new medical technologies. In addition, the results of existing empirical studies describing the influence of various factors on the success of introducing new technologies in medical organizations and on the speed of their spread in the country (region) also required study.
Secondly, an analysis of the mechanisms of government influence used abroad on the processes of introducing new medical technologies and the accumulated experience of stimulating innovative activities in medical organizations.
Thirdly, identifying the features of organizing the process of introducing new medical technologies in Russian medical organizations of different types and forms of ownership.
Fourthly, identifying opportunities for improving government regulation in the field of introducing new medical technologies and developing appropriate recommendations.
It should be emphasized that beyond this study the issues of regulating public procurement of new equipment are left to the extent that they are universal in nature and are not specific to the healthcare sector.
The main results of the research performed are presented in this book.
The first chapter introduces the reader to theoretical models that describe clinic behavior in relation to the introduction of new medical technologies, as well as empirical studies that explain the role of various factors influencing decisions to introduce new technologies.
The second chapter is devoted to the analysis of foreign experience of state regulation in the field of introduction of new medical technologies.
The third chapter examines the features of the decision-making process on the introduction of new medical technologies in Russian state and municipal medical institutions, in private clinics, as well as the problems of regional planning and financing the purchase of medical equipment.
The authors express deep gratitude to the heads of health authorities, state, municipal and private medical organizations Kaluga region and St. Petersburg, as well as experts who took part in this study.
The choice of behavior model by a medical organization regarding the introduction of new technologies is influenced by institutional factors, characteristics of medical institutions, and features of the technologies being introduced. This chapter will systematize theoretical models that explain the decision-making process for introducing new medical technologies in hospitals and empirical studies that explain how various factors can facilitate or hinder the spread of new technologies in healthcare. However, since the introduction of new technologies in this area differs from other sectors of the economy, the features of technological innovation in healthcare will first be considered.
The introduction of new medical technologies is associated with high costs. Health care spending has increased in all OECD countries over the past decade, with average annual spending growth of 4.7% between 2000 and 2009. The share of these costs in GDP increased from an average of 6.9% in 1990 to 9.5% in 2010.
Russia lags significantly behind OECD countries in terms of spending on healthcare in general and on the purchase of medical equipment and other medical products in particular. In terms of the share of healthcare expenditures in GDP, our country lags behind OECD countries by almost 2 times: in 2010 this figure was 5.1%. The gap in per capita spending on medical products is much larger (Table 1.1). Accordingly, the level of equipping of medical institutions with modern medical equipment is also different (Table 1.2).
Data characterizing the export of medical products show that the volume of sales on the global market of medical devices and equipment is constantly growing, even in the period after the 2008 crisis (Table 1.3). The share of medical products in total world exports has also increased. Only in 2010 did it decrease slightly, apparently due to a slowdown in the growth rate of health care spending in many countries (Table 1.4).
Imports of foreign medical equipment to Russia also grew during this period, and in almost all positions (Table 1.5).
Table 1.1. Spending on medical devices in selected OECD countries and Russia in 2009 per capita, US dollars
Source: [Ministry of Industry and Trade, 2011, p. 12].
Table 1.2. Differences in the level of equipment (number of pieces of equipment per 1 million inhabitants) with medical equipment in developed countries and in Russia
Source: [Ministry of Industry and Trade, 2011, p. 12].
There are more than 20 thousand manufacturing companies of medical equipment and medical products in the world. However, the 30 largest producers account for more than 60% of output. The profitability of companies producing medical equipment is higher than in the pharmaceutical manufacturing sector, since the state regulates the industry less, and the development and testing cycle of new products is shorter. The largest manufacturers of medical equipment in the world are companies registered in the USA, Europe and Japan (Table 1.6); 40% of all medical equipment is manufactured in the USA.
In Russia, according to the Ministry of Industry and Trade [Development Strategy..., 2011], the medical device market is absolutely dominated by foreign manufacturers; they account for 82% of sales. The most popular companies are Dräger Medical, General Electric, Philips, Siemens AG, MAQUET. Domestic companies, as a rule, are engaged in the production of non-innovative products.
Table 1.3. Volume of world exports of medical devices in 1995–2010, million US dollars
Source: .
Table 1.4. Share of exports of medical devices in total world exports in 1995–2010, %
Source: Calculated from UNCTADstat data.
Table 1.5. Import of medical equipment to Russia, million US dollars
Source: [Rosstat, 2011, p. 309].
Table 1.6. The world's leading manufacturers of medical equipment, 2008
Source: .
The peculiarity of medicine is that there are not many radical (breakthrough) technological innovations born in the laboratories of medical research centers. Most new medical technologies are based on discoveries and inventions in other fields that have been borrowed or adapted to medical needs, such as electronic diagnostics, lasers, ultrasound, magnetic resonance, etc. In turn, these discoveries have made it possible to raise medical research to a new level and gave rise to new discoveries. It is also worth noting that in the case of medical devices and products, a significant part of innovation appears directly in the process of clinical practice.
Another important difference in medicine is that new technologies come a long way here. clinical trials, identifying side effects, adaptation, registration before they are put into practice. Thus, new medical technologies are usually the result of the interaction of research and industrial laboratories from different fields of science with the health services themselves. Therefore, the process of developing and implementing new medical technologies can rarely be adequately described using a linear model of innovation: basic research → applied research → targeted development → sample creation and promotion → implementation → use.
Today, innovation in medicine refers to a fairly wide range of products and practices, often indirectly related to medical activities. According to Colin Beeken Rye and John Kimberly, innovation is “any single material item or practice that represents a significant deviation from current embodied knowledge, determined as such (deviation) by the collective judgment of individuals from the field in which the new item (practice) appears for the first time." They include clinical and administrative innovations such as medical procedures, biopharmaceuticals, medical devices, and evidence-based medicine research ("practice") in health care. evidence-based medicine), as well as management and administrative practices of the health care delivery process.
The subject of this study is the correlation of innovations that are directly related to medicine with management and administrative practices. That is why it is preferable to use a narrower definition of innovation in medicine, proposed by A. Meyer and J. Gose, according to which such innovations are “significant deviations from previous diagnostic, treatment or prevention techniques, determined as such by the collective judgment of experts in the field.”
Healthcare is usually classified as a knowledge-intensive sector of the economy. According to the European Statistics Agency, the global pharmaceutical and medical industry accounts for the lion's share of all global innovative developments (Table 1.7). The pharmaceutical industry is the high-tech sector with the highest value added per employee and the highest ratio of research and development (R&D) expenditure to sales. The medical industry ranks fourth in terms of Ratio of R&D Spending to Sales. In 2007, the global pharmaceutical industry accounted for 19.2% of all R&D expenditures, and the medical industry accounted for 1.8%.
Table 1.7. Contribution of industry sectors to total research and development expenditure based on 14,002 leading global companies, 2007.
* ICB – Industrial Classification Benchmark – classification established by FTSE (Financial Times Stock Exchange) & Dow Jones. Source: .
And yet, despite significant investments in new medical technologies and medicines, in many developed countries experts note the high conservatism of the healthcare sector and the insufficient level of implementation of developed medical technologies. The current situation is explained by various reasons, but two are most often mentioned.
Firstly, passivity of medical institutions. There are three main approaches to introducing innovations in organizations providing services to the population in general and medical services in particular: passive, supportive and active (Table 1.8). This classification is based on the degree of involvement of the organization in the process of introducing new technologies.
Some researchers even suggest using different terms to describe the process of introducing new technologies depending on how it is managed. For example, the term "penetration" ( diffusion) is proposed to be used in relation to the passive acceptance of new technologies, the term “diffusion, dispersion” ( dissemination) refers to the active and planned adoption of technologies, and the term “implementation” ( implementation) - for active efforts made by the organization to ensure a strategic line to maintain the innovation process.
The passive process of innovation is characterized by the fact that a particular new technology enters the organization by chance, and the organization adapts to implement it. The penetration of innovation is not specifically stimulated.
The supporting process of introducing new technologies assumes that the organization is aware of the need for innovation, therefore new technologies are discussed, their implementation is carried out when an appropriate decision is made (formal or informal), after which special events to support the implementation of innovation.
Table 1.8. The process of introducing new technologies in organizations providing services to the public
Source: .
The active process of innovation is based on a systematic and planned analysis of new technologies, streamlined management procedures built into the overall management of the organization. An active decision-making process about innovations is impossible without the effective interaction of all its participants, so the presence of connections, communication platforms, etc. is often cited as the most important factor influencing the process of introducing new technologies.
According to a review of numerous works on this topic, conducted in 2004 by researchers from the UK, most medical organizations adhere to a passive or supportive approach to innovation, and therefore the intensity of the spread of new technologies in medical institutions is lower than in other areas of the economy.
The second reason for the greater technological conservatism of healthcare compared to other sectors of the economy is that in healthcare today, the opinions of patients and their relatives are still poorly taken into account when developing new technologies, while in other industries, focusing on the needs of end consumers is the most important driving force introduction of new technologies.
There are generally three drivers of innovation: prices, technologies and users. It is generally accepted that firms begin to introduce new technologies either to reduce prices for their products, or for the sake of new opportunities that the emergence of new technologies provides, or under the influence of demand. Moreover, all three driving forces of innovation are not mutually exclusive, but can work simultaneously.
Using this approach, the Danish analytics company FORA tried to explain the reasons for the low rate of innovation in some areas, including healthcare. According to Danish analysts, it is price competition that is most well studied by economists, but in the healthcare sector, minimizing prices is not the dominant interest in introducing new technologies. Innovations resulting from the development of new technologies are also quite well studied. The desire to become a technological leader in their field as a conscious strategy is characteristic of many manufacturers of goods and services, including medical institutions. Invention new technology leads to the introduction or improvement of a product/service. However, it requires the formation of appropriate demand for it.
In contrast, innovation driven by user needs ( user driven innovations), based on consumer needs. The task of service providers is to catch trends and sense user requests for future products/services, rather than relying on existing technological capabilities. IN lately It is these innovations that companies are paying more and more attention to, but not yet in the healthcare sector. In many respects, the lag of the healthcare sector in this area is due to the fact that medical services, being a trusted benefit, are purchased on the recommendation of doctors, and the patient often cannot independently assess either the required set of services or their volume. On the other hand, the provision of medical services is often carried out under conditions of local monopoly, and this in itself is a limitation for the spread of new demand-driven technologies.
Moreover, numerous studies indicate that new technologies in medicine are the most important reason for the growth of health care costs, and the most effective (in terms of “cost-benefit”) of emerging technologies are not always the ones to be implemented. The concern of governments in developed countries with the constant increase in health care costs has led to the emergence of theoretical and empirical studies devoted to the diffusion (introduction and use) of new technologies in medical institutions and the identification of factors that promote and hinder the diffusion of new technologies in medicine.
