Leveraging CMU science and engineering to reinvent reinvention.

The Disruptive Health Technology Institute (DHTI) at Carnegie Mellon University (CMU) was established through endowments and research funding from the Heinz Endowments and Highmark Blue Cross Blue Shield. The goal of the DHTI is to accelerate the identification, validation and adoption of technology that will simultaneously transform the quality, affordability, simplicity and accessibility of health care solutions. The hope of value-based healthcare is dependent on providers, payers, innovators, industry and government working as a team to benefit the people that depend on them for their health and wealth security. DHTI has created an innovation ecosystem where payers, providers, inventors and collaborators can share goals, data, ideas and solutions while coordinating the rapid assessment of the most exciting solutions to vexing problems in healthcare. 

Like many healthcare innovation ecosystems around the United States, DHTI has established programs that provide clinical and payer data-driven insights about the volume to value transition to scientists and engineers at CMU and beyond. Using these insights, CMU inventors are developing targeted technologies. DHTI is replacing the classical model of academic scientists and engineers creating technology that then hunts for a problem to solve. The DHTI process starts with teams of CMU scientists that first understand the details of healthcare problems and then develop solutions. There certainly is no shortage of effort being focused on healthcare technologies in the United States. Together, government and the private sector invest $120 billion annually on healthcare research and development. Health-related startups attract a substantial portion of venture capital dollars, second only to Internet companies. Yet, too often, healthcare R&D can be a disjointed and protracted process. Even the best ideas can run into insurmountable barriers in navigat­ing through proof of concept, clinical trials, regulatory approvals, acceptance by provid­ers and reimbursement by government and commercial payers. DHTI seeks to streamline the process itself and deliver value by targeting rapid adoption and widespread benefits.   

In the first years of DHTI, the partnership between a payer, providers, innovators and collaborators was bolstered by agreements to enable seamless collaboration, including the sharing of anonymized payer data that provides deep insights into promising areas of opportunity for enhancing wellness while containing costs.  We began identifying research foci by convening a series of structured discussions and brainstorming sessions with CMU Principal Investigators, clini­cians, payers, executive leadership and national thought leaders — including advocacy groups, phil­anthropic foundations and benchmarked organizations. These discussions are orga­nized as interdisciplinary Strategic Planning for Disruptive Innovation (SPARK) retreats. The retreats utilize horizon-mapping techniques to determine how technology can increase the simplicity, affordability and accessibility of healthcare delivery; qualify potential opportunities and associated benefits and costs of collaborative R&D; identify poten­tial barriers likely to inhibit innovation and develop strategies to overcome them; and quantify how technology implementation could yield a return on investment for strategic clinical and industry partners. The SPARK retreat process is a powerful platform for targeting areas of strategic importance, initiating multi-disciplinary collaborations and gaining consensus on priorities for programs, funding and partner­ships. Retreat outcomes are used to inform the annual DHTI Request for Proposals (RFP) process and to shape new projects for improved delivery of care and decreased costs. The process also provides ideal forums for networking of diverse communities around common topics, catalyzing relation­ships among innovators and clinicians and setting the stage for effective technology development and clinical trials.

CMU teams are currently focused on:

Medical Diagnostics. Projects in this area pursue viable detection devices that integrate solutions to infection sensing, sensor immobilization, signal transduc­tion and processing, power, packaging and communication. Overcoming barriers to acceptance by health providers is a driving concern.

Transforming Care Delivery. Projects address behavioral medicine and thera­pies related to child trauma; tools to help patients, families and clinicians plan, com­municate and enforce choices on end-of-life care; and financial and nonfinancial incentives that a health system may use to improve care efficiency, affordability and accessibility.

Chronic Disease Management. This area encompasses infection prevention and treatment, with a focus on hospital-ac­quired infections; approaches to chronic wound healing that can reduce treatment costs while improving outcomes; and pain management approaches that avoid or mitigate the addictive potential of the most effective current therapies.

Computational Healthcare.Projects in this area apply data mining and machine learning; guide patients as they tackle healthcare challenges; develop expert systems responding to personalized patient profiles; support data collection and analysis to inform personalized care decisions; and utilize tools that simulate real patients and clinical environments.

Re-Engineering the Healthcare System. This area of focus encourages develop­ment of new care delivery models. For example, a current DHTI project is using an algorithmic approach to revisit the ideal structure of a cross-functional care delivery team compensated in a manner that drives higher quality.

Medical Robotics. Projects in this area address orthopedic robotics, including the incorporation of new imaging technolo­gies and mechanical devices that reduce risks of collateral damage to surrounding areas; and automated decision support using data analytics or automation to decrease costs and increase safety and quality control when dispensing and monitoring drugs.

Moving Forward

DHTI has built a solid foundation but was always designed to be an ecosystem that extended its reach beyond Pittsburgh. DHTI has identified three key barriers to sustainable success.  

First, although DHTI now excels at filtering ideas and technologies that are proposed as part of the original strategic alliance with Highmark, there remains a national need for a “disruptive potential filter” that can be applied to the healthcare/medtech, startup and entrepreneurial community. The filter would use data (payer and clinical) to validate and fine tune those ideas that are likely to be disruptive and transform quality and affordability. Put simply, a real barrier for DHTI is that the success (clinical and commercial) of new technology is very difficult to predict.

Second, payers make all final decisions on reimbursement and very little has changed in their skepticism about the value of technology (particularly medical device technology) and the unpredictable path that separates both good and bad ideas from progressing to the market. At a recent gathering of health system CEOs the group was asked, “If we could freeze technology and just focus on fixing the health care system, versus continue to deploy new technology in order to try to fix the system, which would you do?”. Their answer was almost uniformly that new technology is not necessary in order to “fix” healthcare. This combined concern of payer and provider leaders about the value of new technology has created an environment in which even outstanding high value technology can struggle to make its way to patients in a timely way. Put simply, the payer community has no mechanism as a group to accelerate technologies that they believe in.

Finally, the clinical trial and pilot programs that are designed to convince physicians and investors of the validity of a new technology are often misaligned with the data collection needs of a payer when deciding whether to agree that the technology is no longer experimental.  Also, the same clinical trial that convinces a payer to designate a new technology as non-experimental may not collect enough information to warrant reimbursement at a level that is being sought.  Put simply, the people with the critical data on how a new technology impacts health and wealth are generally not part of assessment strategy design.

We create strong partnerships across payers, providers and innovators. Making smart solutions widely accessible hinges on acceptance by payers and providers. Through DHTI, payers and providers are integral partners from the outset, iden-tifying high-priority opportunities that can have far-reaching impacts on cost reduction and quality improvement. In the hands of world-class computer scientists, payer data is translated into insights on market needs. The result? Exciting solutions are introduced to a ready-and-waiting marketplace.

We welcome — even insisting on — fresh perspectives. Disruption generally does not come from expected sources. Indeed, we believe CMU’s lack of a med-ical school is advantageous. DHTI fosters partnerships between clinicians and diverse CMU disciplines in a wide range of basic and applied sciences, as well as information science, behavioral econom-ics, engineering, entrepreneurship and human-centered design. We find that a mix of perspectives dramatically expands the variety and originality of promising solutions brought to the table.

Our aim is to spur successful — and some-times surprising — solutions to pressing problems in healthcare delivery.

We unite innovators, payer and provider to tackle
high-priority challenges.

Contact Us

  Phone: 412-268-6920
  Email: Lynn M. Banaszak