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  • Uli K. Chettipally, MD, MPH.

The Moonshot and The Low Hanging Fruit - Path to Innovation in Healthcare


American healthcare, according to many observers, is at a stage where change is inevitable. There are several movements that are creating this perfect storm. Increasing cost of healthcare, digitization of healthcare data, demand for consumer convenience and availability of powerful information technology is creating a perfect storm. This change can happen is small spurts or in large swoops. Innovators are in the driver’s seat.

A Moonshot is described as "an ambitious, exploratory and ground-breaking project undertaken without any expectation of near-term profitability or benefit and also, without a full investigation of potential risks and benefits".

"Now it is time to take longer strides - time for a great new American enterprise - time for this nation to take a clearly leading role in space achievement, which in many ways may hold the key to our future on earth" John F. Kennedy

From the time when President John F. Kennedy addressed the Congress in 1961 to current day, we have been fascinated by moonshots. In recent times, the term moonshot has been popularized by Google and others, working on projects that required a large amount of capital, taking on a huge risk of failure and the potential to change the world if successful.

MOONSHOT = HEAVY INVESTMENT + HIGH RISK OF FAILURE + HUGE POTENTIAL BENEFIT

President Obama during his 2016 State of the Union Address, appointed Vice President Biden to lead a new, national Cancer Moonshot program which will focus on "making a decade of progress in preventing, diagnosing, and treating cancer in 5 years, ultimately striving to end cancer as we know it". Although this proclamation sounds modest compared to other moonshots declared recently in the technology world, the fact that the government is pushing focused research to solve a specific healthcare problem is laudable.

Let's compare this program with our prior definition: It does require a significant amount of investment. The President allocated $1 billion towards this project as an initial investment. Considering that we spend more than $3,000 billion a year on healthcare, this may look small.

The risk of failure may not be that high. If you want to double the speed of research in cancer, it's not an unattainable goal, mainly because the technology to accomplish it is already here. Data can be generated, collected and shared much easily. It is more of the meeting of the minds to focus on the problem to accomplish this goal.

Potential benefits of successfully reaching this goal are tremendous. Many lives could be saved. Many cancers that are now considered incurable may be prevented. Hidden cures may be discovered. There is no doubt about the huge benefits of speeding up the research in this area.

The phrase low hanging fruit is used to describe a course of action that can be undertaken quickly and easily as part of a wider range of changes or solutions to a problem. This term was popularized during the 90s in the business culture. Low hanging fruit is the easiest problem to solve. It needs little resources, has minimal risk and the benefit is modest.

LOW HANGING FRUIT = MINIMAL INVESTMENT + LOW RISK OF FAILURE + MODEST BENEFIT

There are many ideas which need minimal investment in healthcare to make the quality better and decrease the cost. With the increasing use of electronic health records, data is easier to collect, collate and analyze. The technology to study huge amounts of data is already here. Many of the data problems have already been solved in other industries. We surely can borrow the methodologies from banking and technology industries.

What are the problems we are trying to solve? For one, American spending on healthcare keeps increasing. According to a recent study, US healthcare spending now accounts for more than 17% of the US economy. Financially speaking, healthcare is the biggest problem that the US is facing right now. With this kind of a crisis on our plate, there should be many more attempts at picking the low hanging fruits and hundreds of moonshots. As the technological advances are moving faster and faster, moonshots become more achievable in shorter and shorter time frames.

In conclusion, both strategies are needed to make progress in healthcare innovation. With the acceleration of technology, the moon shots are getting a little bit closer to the low hanging fruits. Let's take this once in a lifetime opportunity to innovate and make a difference in peoples lives!


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