The day before I was to get married in his backyard, my dad called me from the hospital. He had had a heart attack, and was in the ICU recovering from having a stent placed in his coronary artery. This summer my husband and I celebrated our 10 year anniversary (we rescheduled the ceremony), and that backyard was the site of a family reunion where my father, now a grandfather of three, raised a toast to 10 more cherished years of life and health.
My dad had experienced crushing chest pain and shortness of breath just blocks from one of the top cardiac centers in New York City, and we have often wondered grimly what would have happened if he had experienced these symptoms somewhere else. It stands to reason that his physical proximity to the hospital helped his chances of survival, but according to our recent Colloquium in Healthcare Leadership speaker, Clive Meanwell, once inside the hospital, delays, inefficiencies, and errors have a potent effect on mortality as well. Meanwell is the Chairman and CEO of The Medicines Company, makers Angiox/Angiomax, the anticoagulant my dad most likely received during the stent procedure to help restore blood flow to his heart muscle.
Clive Meanwell cited findings from a Yale research team that looked at the attributes of high performing cardiac units and showed that most hospitals lacked several of these key attributes, leading to excess mortality. In fact, the reduction in mortality that was feasible with process improvements was far greater than what could be achieved by replacing one medication with a more effective one.
And this is where Meanwell and The Medicines Company depart from the expected pharma or biotech approach. While his industry is fixated on invention - new chemicals, new treatment regimens, and new uses for patented drugs - he is fixated on innovation. When a salesperson sells a half-inch drill bit, they are solving a problem for someone who needs a half-inch hole, not a chunk of metal. Innovation, Meanwell claims, is about delivering value; about starting by asking what is needed. “And when you ask doctors,” he says, “they don’t say ‘we need more drugs.’”
So Meanwell and his team innovated a new business model for creating value in acute care, one that rewards appropriate use of their patented drugs but, according to Meanwell, has no incentive to push overuse. In fact, by selling hospitals and health systems a package that includes clinical process improvement and data management services, Meanwell claims he can be profitable without necessarily selling any of his products at all. The company’s accounting books track not just sales, but number of lives saved and reductions in hospital length of stay. This is a mission-driven company that weaves its mission right into its bottom line, and one that seems well suited to thrive in the era of accountable care and data driven system transformation.
I’ll admit, as a midwife in a health IT startup, I did not expect to draw much inspiration from the pharma and biotech offerings in the fall Colloquium. But I came to Yale precisely because I wanted to innovate a business model for the maternity care transformation. My company is passionate about improving maternity care, and exuberantly mission driven. We develop and sell technology and data management tools to support high-quality, high-value care, but technology alone is not sufficient to achieve the vision. We have invested considerable resources to recruit maternity care leaders and innovators and can maximize the value of our products by leveraging this expertise and packaging it with our technology. I want to thank Clive Meanwell for coming to Yale and offering an inspiring business model to achieve this.