Hinnovic » Innovations

Scientists’ responsibilities in the public understanding of science – The case of neuroscience and ADHD

mhivon — Tue, 05 Jul 2011 06:00:56 +0000

Most of us rely on the media to learn about scientific innovations and breakthroughs. Where health is concerned, the media are often accused of looking for sensational stories, presenting incomplete, unbalanced, uncritical or misleading information. Yet, scientific journals and experts constitute, by and large, the main source of information for science journalists. Would it not be possible that misleading conclusions in the media stem, at least in part, from misrepresentation of data in scientific papers?

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Jouer pour mieux se porter

mhivon — Tue, 10 May 2011 06:00:28 +0000

Ces dernières années, la santé publique a déployé beaucoup d’efforts pour documenter les aspects négatifs du jeu, du moins au Québec (Papineau, 2010). Chaque semaine, les médias publient un article, présentent un reportage ou une publicité sur les dangers de la dépendance aux jeux de hasard ou de la cyberdépendance aux jeux vidéo. L’équipe d’Hinnovic a aussi exploré ce phénomène.

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Understanding the Value of Health Innovation

plehoux — Mon, 14 Mar 2011 06:00:18 +0000

In a Panel hosted by Research Canada, I was asked whether a major obstacle to a well-thought out integration of health technology into our health care system may be our focus on affordability rather than its desirability. These are terms I used in my book, “The problem of health technology”, which called for a clarification of what we mean by the value of health innovation. Is it something that relates to our purse, or to the purposes behind health technology?

To engage in such a debate productively, we first have to get rid of the current rhetoric according to which public health care systems will no longer be able to absorb technological innovations because the cost of medical technology will necessarily continue rising; that public health care systems will collapse and patients will have to pay directly for medical technology. This rhetoric is highly manipulative and it ignores that fact that private health care systems too cannot absorb each and every health innovation.

Health care systems have been rendered unsustainable because those who have created medical technologies during the past thirty years did not care about sustainability and because the most important driver behind medical innovation during that period have been capacity and willingness to pay. In the 1980s, health care systems were being developed and third-party payers were keen to offer various health care packages. As a result, there was a seemingly ever-expanding market in which it was possible to create innovations that, by design, were complex, costly and which overall increased our dependence upon specialized medicine.

The medical technologies we have today are not the way they are because they have to

Like you, I’ve never seen a technology falling out of the sky. But because I was trained in industrial design, I know that technologies are designed in a certain way by people who make various assumptions about what other people may need, are likely to value, desire, adopt and pay for. For instance, one has to decide whether a given innovation will be used by a nurse, a medical specialist, or a patient. One has to decide whether a given innovation will be used in a tertiary care hospital, a walk-in clinic or a patient’s home. Then, one has to decide how costly a given innovation will be. In other words, a series of decisions are made over the course of technology development —upstream—, which ultimately have a direct downstream impact on health care systems. The problem is that these decisions rarely take the needs and challenges of health care systems into account.

The archetype of such development is medical imaging. Different types of information are generated by various types of device; one does rarely substitute to another and there is a need for constant maintenance and upgrading of each system. Moreover, the real impact of medical imaging devices on patient management is still very much debated. This is an example of a technology where the key end-users are medical specialists and where reinforcing their ability to diagnose, monitor health states and do exciting research becomes paramount. But when the key end-user is the patient, like for instance insulin injection devices and monitoring systems for diabetic patients, the technology rather seeks to support the patient’s autonomy and ability to intervene appropriately. Here, another actor is empowered through medical technology and in a way that may be more compatible with supporting the sustainability of health care systems.

Reconsidering what innovations are for? And for whom?

As argued in my book, it is possible to design technologies in a different way, one that can help health care systems achieve better outcomes. But comparing the respective purpose or social relevance of different health interventions is something we’re not very well equipped to do, both from a research and policy perspectives. It does require making value-laden judgments explicit. From a public health perspective, to define which innovation is more desirable requires understanding what makes some people healthy and others not (see Evans et al., 1994). And this doesn’t have much to do with our genes, or with technological solutions that are in “search of a market.” Beyond a few things that individuals may do or refrain to do in order to live healthy lives, the overall outcome for a population is largely determined by its social structures, e.g., by its capacity to redistribute wealth and create healthy places to live and work in.

So far, the way in which health technologies have been designed has threatened the sustainability of private and public health care systems. It is not the other way around; it is not the systems that are not able to absorb innovations. We have to understand how and when a given technology brings more value to health care when compared to others. And then reconsider what kinds of R&D investments should be made for the future of our health care system, giving priority to those that will generate more significant population health outcomes.

Author :

Pascale Lehoux, Ph.D.

REFERENCES

Evans, R.G., Barer, M.L., and Marmor, T.R. (Eds) (1994). Why are some people healthy and others not? The determinants of health of populations. New York: A. De Gruyter.
Lehoux, P. (2006). The problem of health technology. Policy implications for modern health care systems. New York : Routledge.

Children and the architecture of children’s hospitals

mhivon — Mon, 21 Feb 2011 06:00:56 +0000

Still interested in finding clever and socially relevant solutions for health? This month, we invite you to listen to David Theodore’s talk presented at the TEDxMontrealQuartierLatin, an event hosted by the Hinnovic team on October 1st, 2010. David shares his views on the history of pediatric hospital architecture and describes an original research that relied on an active participation of children and young people.

Find other refreshing design stories on TEDxMontrealQuartierLatin website.

David Theodore on the architecture of children’s hospitals

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Speaker :	David Theodore Ph.D. Candidate Graduate School of Design Harvard University
Text introduction :	Myriam Hivon, Ph.D.

Agir maintenant sur la santé des communautés en transformant l’environnement bâti

mhivon — Wed, 19 Jan 2011 11:00:51 +0000

En juin dernier, nous avons publié un dossier sur les villes en santé. Adoptant l’angle des politiques de santé publique, nous avons examiné les liens incontestables qui existent entre l’environnement urbain et la santé globale de la population. Le dossier a clarifié où en est le mouvement des villes en santé ainsi que les défis qu’il reste à relever.

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Transition vers la résilience locale

hurfer — Wed, 19 Jan 2011 10:00:34 +0000

L’ère du pétrole à bon marché touche à sa fin. Nous approchons du « pic pétrolier », soit ce moment où la production mondiale de pétrole commencera à décliner du fait de l’épuisement des réserves d’or noir. Quel est le lien entre le pic pétrolier et les innovations en santé dont traite ce blogue?

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Changing the Built Environment to Encourage Physical Activity

mhivon — Wed, 19 Jan 2011 09:00:23 +0000

Get Active Orlando (GAO) was originally part of the Robert Wood Johnson Foundation Active Living by Design initiative. Started in 2004, with much learning along the way, GAO has evolved its approach for creating built environments that encourage physical activity.

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Le pouvoir transformateur de l’environnement bâti

hurfer — Wed, 19 Jan 2011 08:00:50 +0000

En Amérique du Nord, on considère encore la banlieue comme le lieu qui permet une qualité de vie optimale. Pourtant, vivre en banlieue n’est pas automatiquement synonyme de vivre en santé. Dans cette entrevue, l’architecte Dominique Laroche discute de modèles alternatifs à la vie de banlieue et présente son ambitieux projet d’imprégner l’imaginaire collectif québécois de l’idée d’un nouveau cadre bâti afin d’agir sur la demande immobilière.

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Enviro-Health All Together!

mhivon — Wed, 19 Jan 2011 07:00:28 +0000

Our health is linked to the quality of our environment. For example, health is affected by how clean our air, water, and surroundings are; by how the neighbourhood is built to enable physical activity; and, by the quality of our social networks and the information available to us.

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Risque accru de mourir pour les habitants de micro-ilôts de chaleur urbains

mhivon — Wed, 19 Jan 2011 06:00:08 +0000

On sait que lors de journées chaudes, le risque de mortalité augmente. Ce qui est moins connu, c’est qu’il y a une forte variation des températures à l’intérieur d’une même ville et selon les types de logis habités. Les personnes qui se trouvent dans des micro-ilôts de chaleur urbains (à la maison ou en institution) seraient plus à risque de mourir avec l’augmentation de la température en été.

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Studying “Bixi-ville”

pboinot — Wed, 14 Jul 2010 06:00:14 +0000

Even with the best intentions, there is always a reason to hesitate to use our bicycle to transit: there is no place to store it at destination or for the return ride we would have to go uphill. To address these excuses, a public bicycle share program (PBSP) might be a good solution. In this interview, Daniel Fuller, a Ph.D. candidate in public health, presents BIXI, a PBSP in Montreal and explains how this innovation can help adopt a more active lifestyle.

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Quand les innovations en santé s’invitent au bar

gdaudelin — Tue, 27 Apr 2010 13:00:19 +0000

La scène semble surréaliste. Un bar bondé d’un quartier populaire d’une grande ville est le théâtre d’une discussion animée autour, non pas des performances de l’équipe de hockey locale, mais des innovations médicales. Le public, informé et intéressé, participe activement au débat lancé par un animateur et des chercheurs invités. Malgré un calme relatif, l’ambiance détonne avec le cadre habituel des conférences scientifiques dans des institutions universitaires. Que se passe-t-il? Un bar des sciences est en action!

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