I have your book, Dream Machine, here in my office. It helped me understand the history of computing and Dr. Licklider’s role.

My main job is running a non profit, Restore Mass Ave, which adds trees to DC. But I’m preparing my own blog, on topics relating to climate change. Much of my past writing fits into this theme.

Man i love reading your blog, interesting posts !…

I Googled for something completely different, but found your page…and have to say thanks. nice read….

joel

My experience is that government policy interferes with innovation in health care. Innovation is not rewarded, but rather penalized. There are efforts to standardize procedures, but these are often driven by utilization of financial resources and legal risks, rather than innovation. Besides government regulation and policy, there is the problem of insurance. Many insurance companies only pay for specific procedures based on variables they determine rather than being driven by patient care. The insurance companies go so far as to limit the medications available to the patient. They limit their consideration to the specific formularies that the company approves.

Innovation involves risks. Anytime procedures are performed that are outside of the defined “standards of care”, they are frowned upon at a minimum. In hospitals, there is usually additional paperwork and scrutiny when someone deviates from the accepted procedure, which tends to stifle innovation. Innovation is also stifled by lawsuits which make anyone who attempts innovative procedures or techniques look negligent. They often define negligence as deviating from the accepted procedure. Since most people in health care do not want to be sued, they stay within the “accepted” procedures and policies.

The systems set up for health care have put restraints on innovation. There is some innovation, but even that is limited to following the established procedures for trials, studies, etc. If government and insurance companies took off the restraints, health care could operate more like a science rather than kitchen that only prepares approved dishes prepared in approved methods.

The CTSA program addresses this re-engineering effort in two fundamental ways. First, it seeks to remove some of the structural obstacles that might impede clinical and translational research by supporting the development of research infrastructure (e.g., biomedical informatics, etc.) and the streamlining of internal processes (such as the Institutional Review Board process.) Second, it funds the development of new training programs to train the next generation of clinical and translational researchers, and supports the development of institutional career paths and incentives to attract these young investigators to clinical and translational research and retain them over time.

If you want more information about this, there is a good website on the program which you can find at http://www.ctsaweb.org.