By Allison Proffitt

April 8, 2008 | At a roundtable hosted by the MIT Center for Biomedical Innovation last Wednesday, a panel of experts championed the cause of innovation in health care.

“Innovation is many things,” said moderator Charles Cooney, professor of chemical engineering at MIT, but he stressed that innovation must occur across boundaries in government, academia, and industry. Finding the right fit for each player, though, is difficult.

These problems are the “biggest domestic policy challenges in the twenty-first century,” said Mark McClellan, current director, Engelberg Center for Healthcare Reform and a former FDA commisioner and former CMS chief.  “There’s a rising level of public concern,” McClellan noted, and a need for “more effective ways of getting treatments to patients who need them.”

It’s the iron triangle, said Alan Krensky, deputy director of the National Institutes of Health. “OPASI [Office of Portfolio Analysis and Strategic Initiatives] at the NIH has a vision to bring groups together across boundaries,” Krensky said, “But how will industry, government, and academia do this?” Krensky believes that this is an opportunity for philanthropic organizations. “They can get into the middle area and really develop cures, change quality of life, affect prevention.”

 “Government has a role in defining the end state, what we want to accomplish,” said Julie Gerberding, director for the Centers for Disease Control and Prevention. “Then the government needs to get out of the way, and that’s a struggle.”

 “We don’t have the luxury of venture capital,” said Gerberding, explaining that CDC answers to Congress for how it spends its money and is, as a result, fairly risk adverse.

Randall Lutter, deputy commissioner for policy at the Food & Drug Administration, extended the idea of public expectations. “Trust and predictability matter because we must maintain those while regulating,” he said. “Trust is important because patients and the health care community rely on us for safety and efficacy and we operate in a fishbowl environment.”

But even in government agencies, panelists saw opportunities to encourage innovation in health care.

“Not everyone assumes government and innovation can fit together,” admitted Gerberding. But she listed five ways that CDC believes government can foster innovation: offering ideas, investing in innovation with grants, building a “collective wisdom” as informants, innovating with creative science even with challenges, and serving as integrators to bring people together to work across boundaries.

Gerberding highlighted health as a “huge pipeline innovation.” Investments have been made in basic research translated to bedside products and tools and then those tools incorporated into physician practice, she said, and called for the same pipeline to be developed for health promotion yielding products, drugs, and tools to promote health and research to measure and quantify those efforts.