3 Presentations

• 
  10:30 AM - 11:00 AM

  Disruptive Opportunities of Non-Invasive Prenatal Testing (NIPT) in Maternal and Natal Health Services Management

  • Henni Tenhunen, presenter, Aalto University
  • Karita Reijonsaari, Aalto University

  Background: Non-invasive prenatal testing (NIPT) based on next-generation sequencing of cell-free DNA in maternal plasma has been adopted in the Hospital District of Helsinki and Uusimaa as an alternative screening method for detection of fetal chromosome aneuploidies for women with increased risk factors. Several private clinics in Finland also offer NIPT. NIPT is a prominent application of personalized medicine (PM), a field using diagnostic tools to identify specific biological markers to provide the right treatment in the right dose to the right patient at the right time.

  Aims: The purpose of this study is to investigate the disruptive opportunities and challenges of NIPT drawing on theories on disruptive technologies and business model innovation as a lens. The focus is on public and private maternal and natal healthcare service providers. The research problem builds on whether NIPT can disrupt the prenatal testing market and what are the implications regarding e.g. value propositions, channels, and key partnerships.

  Methods: Literature review and interviews with service providers, NIPT specialists, maternity care nurses and midwifes are carried out.

  Results: Disruptive opportunities of NIPT can be categorized based on, inter alia, the new risk profiles and skill sets required. Examples include increased counseling by geneticists, advanced sample logistics, and the effect of fewer invasive operations.

  Conclusions: The research provides new insights into utilizing the business opportunities of NIPT and similar PM technologies. The results can also be employed to handle management challenges, as there is a new level of costs and complexity. Further studies are needed for evaluating potentially disruptive genomic innovations in other healthcare areas.

• 
  11:00 AM - 11:30 AM

  Informing decisions on the provision of protective suits for use in decontaminating patients exposed to hazardous substances.

  • Luca Grieco, presenter, University College London
  • Martin Utley, University College London

  Events involving release of chemical, biological, radiological or nuclear (CBRN) substances may prompt the need for decontamination procedures in aid of exposed casualties prior to further treatment. Powered Respirator Protective Suits are needed by healthcare workers to perform such procedures in order to avoid direct contact with contaminants.

  In collaboration with representatives of the UK Government Department of Health and NHS England, we developed an analytical framework to determine the provision of protective suits required by Ambulance Services and Emergency Departments across England if they are to have an accepted degree of resilience to locally identified hazards.

  Given the different nature of the processes characterising decontamination procedures, the two types of healthcare services were treated separately. Ambulance Services reach the scene of an event and face a group of contaminated people needing treatment, thus a simpler multiplicative clearing model linking the expected number of casualties to the needed number of protective suits was built. Emergency Departments receive contaminated people at a certain rate (varying with time), usually upon manifestation of symptoms, therefore requiring a more complex model based on queueing theory results and assuming a time-varying patient arrival rate.

  We will describe the framework and how it has been used in conjunction with information in the public domain and expert opinion to inform recommendations on Emergency Department and Ambulance Service holdings.

• 
  11:30 AM - 12:00 PM

  Operations research in the eyes of a Subsaharan African faith based hospital

  • Emmanuel Ochola, presenter, St-Mary's Lacor Hospital
  • Martin Ogwang, St-Mary's Lacor Hospital
  • Emintone Odong,
  • Dominique Corti,
  • Filippo Campo,
  • Cyprian Opira,

  Many health units, particularly faith based hospitals in Subsaharan Africa tend to be engulfed in patient care with minimal time for reflective work, given the high burden of infectious and non infectious diseases, generally poor and underfunded health care system, difficult working conditions and limited community reach.
  We present the case of St. Mary’s Hospital Lacor, a faith based Hospital that started in 1959, and importantly founded by an Italian doctor and his Canadian wife. It underwent tumultuous times of wars with its effects, epidemics like HIV, TB and Ebola, death of founders, and reducing funding. It also underwent formation of local capacity in care, leadership and research.
  We cite a few recent examples of research in the hospital and its context, showing particularly one focused on health trends in post conflict Northern Uganda that informed the strategic plan and the potential increase of user fees, and an operations research into the analysing the health care processes for the management of Tuberculosis starting from the time the patient arrives in the hospital until they are followed up in the community, with the purpose of improving the process.
  The need for research in the context of busy African hospital contexts, the opportunities, and the challenges of conducting locally relevant and informative research in such contexts is discussed, stressing the need for increased funding and collaboration.