Progress ReportThe Center for Innovation and Outcomes Research
Dr. Craig Smith, Chairman of the Department of Surgery, founded the Center for Innovation and Outcomes Research in 2010. Although the department has a long history of engaging in successful, impacting research, he defined the goals of the center to include a broader view of research. By including "innovation" in the name of the center, the focus was immediately shifted to efforts that would translate results of basic science research and new, previously untested ideas into practical solutions for clinical needs. Outcomes research at the most basic level simply refers to a study of the outcomes of clinical care. However, by including "outcomes research" in the name of the center it charges investigators in the department to study the outcomes of surgical care in ways other than the traditional focus on complications after surgery.
Surgeons often have ideas that have the potential to improve the surgical care of patients. However, most surgeon-generated ideas are never developed because of the challenges associated with developing and commercializing a solution to a healthcare need. Surgeons typically do not have the time, engineering expertise, or the business expertise to design, prototype, test, and commercialize healthcare technology. However, their clinical expertise is essential to the entire process of commercialization. The Center is positioned to increase the opportunity for surgeons with ideas to successfully innovate by providing advice and referrals to appropriate collaborators. To evaluate and facilitate innovative ideas, the Center recommends potential collaborators in engineering, intellectual property, methods of commercialization, and a path to commercialization that would effectively use the broad resources of Columbia University.
The Center is engaged with the Department of Biomedical Engineering and Columbia Technology Ventures in implementing a large grant from the Coulter Foundation. This grant is structured to facilitate collaboration between clinicians with unmet needs and engineers with expertise in designing biologic and/or mechanical solutions to meet those unmet needs. In addition to the engineering support, the grant provides mentorship and advice from the business and investment communities to help faculty inventors develop and move the idea along the commercialization pathway.
Several projects initiated by surgeons in the past few years have resulted in various licensing agreements with companies and institutions. Other projects are in development and have received significant interest from investors or large companies. Examples of projects that are either licensed or in development include the following.
- Single port surgical robotic technology
- Insertable camera for minimally invasive surgery imaging
- Web-based education platform for medical education
- Ventricular assist device
- New construct for white-light based 3D imaging for surgery
- New stapling technology
- Improved technology for introducing pacemakers
- New, optical methods for sterilizing surgical wounds
In 2001 the Institute of Medicine (IOM) defined six important aspects of healthcare quality: Safe, Effective, Efficient, Timely, Patient-Centered, Equitable. Since then, it has become imperative that investigators document and study outcomes other than just the effectiveness of care. In the discipline of surgery, it is now important to investigate not just the safety and effectiveness of surgery (measurement of complication rates), but the overall appropriateness of surgery. Following are examples of studies currently proposed and/or underway.
- Improved methods of ensuring that patients receive surgical care most consistent with their desires and beliefs.
- New methods for facilitating advanced care planning.
- New methods for facilitating truly informed consent for surgery.
- Development and testing of improved methods for assessing performance of surgeons in training.
- Identification of factors that predict adverse outcomes after various types of surgical procedures.
- The long-term outcomes after surgical treatment for breast cancer.
- The long-term impact of minimally invasive surgery when compared to traditional surgical techniques.
- The impact of surgical care on different populations: defining disparities in some populations.
The overriding concept in surgical outcomes research is to determine the appropriateness of surgical care. Although there are emergent situations for which there is consensus that surgical intervention is appropriate, there are many elective situations in which the appropriateness of surgery would depend not just on the disease being treated, but also on the wishes of the patient, the availability of alternatives, the timing and location of the procedure, and other factors such as support for recovery. Research underway in the center will further identify the factors necessary for the optimal use of surgical care.
Goals of the Reemtsma Center
To stimulate and support innovation in the Department of Surgery
- Support translation of ideas through the processes of development and commercialization
- Develop liaisons with
- Engineering faculty
- Columbia Technology Ventures
- Business and investment guidance
To increase the amount and quality of outcomes research in the Department of Surgery
- Provide scientific collaboration and advice to faculty
- Provide a high quality data infrastructure for research
- To broaden the focus of research in the Department of Surgery to include the study of surgical outcomes other than safe and effective
- The overall quality and appropriateness of surgery
- Equitable measure the impact of surgical care on our community locally and our society at large research to guide the elimination of disparities
- Patient-centered research to guide delivery of surgical care that is most consistent with the patients' desires
- Efficient research to guide the delivery of cost-effective and timely surgical care
To develop and support faculty who are committed to innovation and research
To train and mentor residents and fellows to be committed to innovation and outcomes research