by Elizabeth Hofheinz, M.P.H., M.Ed., July 26, 2019
While all human beings possess a need for order and familiarity, some yearn for new horizons. Cleveland Clinic is a magnet for such individuals.
Wael Barsoum, M.D. is CEO and President of
Cleveland Clinic Florida and holds the Robert and Suzanne Tomsich Distinguished Chair in
Healthcare Innovation. He told OSN, “In order to foster an environment that
opens the door for healthcare advances you must have an infrastructure
that supports innovation. If you have a solid foundation of openness and a
clear pathway for scientists, you are on the way to creating technologies and
processes that deliver better healthcare for patients and a better environment
for healthcare professionals.” 
To ensure that the march toward progress is undertaken in a manner that is safe, legal, and in the best interests of patients, Cleveland Clinic has innovation leaders in Cleveland and Florida, with Dr. Barsoum naming Joseph Iannotti, M.D., Ph.D. as the first-ever Chief Innovation Officer at Cleveland Clinic Florida. “Formal medical training does not include information on how to take an idea from its initial outlines to the realm of clinical care to ultimately licensing or spinning it off into a company,” says Dr. Barsoum. “Cleveland Clinic became aware of this need and has addressed it a thoughtful, strategic manner.”
A holder of approximately 50 patents, Dr. Barsoum is routinely asked by surgeons, ‘I have a great idea…How do I get a patent?’
“Surgeons need detailed information on how to work with industry and how to license a product. We take them through all of the necessary steps to be successful in this process.”
While safety is their overarching concern, the innovators at Cleveland Clinic also have to navigate the waters of potential conflicts of interest. Dr. Barsoum: “Someone might come to me saying that they are investigating a new hip replacement and will be publishing data that it is a resounding success. That inventor needs to disclose to patients his or her involvement and potential financial gain. And there are instances where surgeons should not be allowed to do research on a certain product. To handle that and other such issues we have a Conflict of Interest Committee.”
“This committee decides who is allowed to participate in the research and development process…and if someone is allowed to do so then how should the process be managed? On occasion we must tell the inventor that he or she cannot participate beyond the design phase. If someone is the only person in the world who understands how to use a certain immunoassay for a study, then it’s clear they themselves should do the research with oversight. They have to meet that uniqueness threshold or else they need to bow out.”
“We have established committees or groups for all possible eventualities. There are groups that award funds to promising projects, groups to decide if we should commercialize the product in-house, an FDA group, a group for spinoffs, one for private equity, a licensure group, etc.”
In the clinical/medical operations arena, there is ample innovation as well. “Cleveland Clinic is one of the first places in the U.S. to use predictive modeling to manage medical operations. For example, I can tell you plus or minus 5% what the OR volume will be over the next six weeks—as well as what kind of cases we will be handling. Such management accounts for scheduling fluctuations, such as when people go on vacation and we can then free up that OR time for someone else. So, for a given type of surgery you need X number of nurses, Y number of techs, Z number of surgeons, etc. We can manage all of this with a high level of precision.”
“Not only does predictive modeling forecast the average length of stay, but it can tell you whether the patient is likely to be discharged to a rehab facility, subacute nursing, or to home—thus allowing staff to work with the patient and family to make those plans in advance. They can also determine which patients are most likely to be readmitted. Such precise planning has enabled us to achieve some of the lowest TJR length of stay rates in the country…despite the fact that the majority of our patients are sicker than those at other facilities.”
Thus, in embarking on innovation, look out for these challenges, advises Dr. Barsoum. “Do you have the resources required to take a new idea from its origins to full fruition? Do you have an in-depth understanding of how to steer your innovation through the world of the FDA and industry? Do you have the requisite research background to be successful? I am pleased to say that the Cleveland Clinic College of Medicine requires a fifth year that is dedicated to research. Our medical school is tuition-free so that future physicians do not feel forced to go into high-paying clinical medicine, but can instead follow their passion if they are drawn to research and education.”
Asked what “keeps him up at night” Dr. Barsoum told OSN, “When you are neck-deep in an idea and that little voice is telling you that it may be prudent to walk away…that is very tough. If you abandon an idea to which you had devoted countless hours, well then what do you do next? And then there are the times when other parties beat you to the punch. For example, I would love for us to enter the augmented reality space in total joint replacement, but at this point it is a very crowded space…that train has left the station.”
But back to the indispensable aspect of all of this…support. “Surgeon scientists stand a much better chance of innovating if their hospital administration appreciates, supports, and provides time for innovation. Healthcare is changing so rapidly that unless you push the envelope when it comes to innovating better and less expensively, then you will fall behind.”
Stay tuned for Part Two of How Cleveland Clinic Innovates