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Clinically Speaking

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I'm sure you've all seen charts showing the dramatic increase in life expectancy during the 20th Century --- how that in 1900 on average people lived about 47 years, yet by the end of the century life expectancy was around 77 years.

Though improved sanitation certainly played a part, medical innovation not only helped people live longer, but also improved the quality of their lives.

Today, with dramatic advances in microelectronics, a greater understanding of health and disease and new scientific technologies and approaches, we are poised to benefit from a host of new medical innovations -- some of which have the potential to be transformational.

For example, just consider what some of the "top ten" medical innovations for 2008 that the Cleveland Clinic announced last week at its annual Medical Innovation Summit could mean for the future of healthcare. Innovations such as:

* A robotic system that enables surgeons to work in places where their hands can't through tube-like catheters.

* A less invasive way to deliver aortic heart valves through catheters inserted through the groin or a small incision and then expand the valve inside the heart.

* The use of natural biomaterials to replace joint cartilage tissue that is damaged from injury or arthritis.

These and the many other medical innovations in development hold enormous promise -- and could have a significant impact on people's lives.

But every day brings more news about how the mega trends of our day -- demographic shifts, new scientific and information technologies -- are changing our health care system. The big question is how, in the face of these changes, we ensure that medical innovation continues.

Perhaps one of the greatest challenges to innovation is the erosion of public trust in the healthcare system. People are increasingly skeptical of healthcare providers and companies and demanding greater transparency. Increasingly, patients are turning to online communities for advice, rather than to their doctors or the researchers who develop their medicines or medical devices.

This was a topic picked up on at last week's medical innovation summit at the Cleveland Clinic by Johnson & Johnson Vice Chairman Christine Poon during the summit's closing address. Noting the great promise of new medical technology and the decline in trust, she said:

The single greatest opportunity we have in health care today is to re-establish trust with patients. If trust erodes any further, patients won't use innovator products, payers won't reimburse them and policymakers will reject pro-innovation policies.

But there is much that companies and health care providers can do to respond to changing public expectations and demands for greater transparency. As Chris explained in her remarks, for health care companies, as a start, this means being more open about the funding provided for medical education and the resources given to patient and professional societies. It means publishing the results of both failed and successful clinical trials and providing the status of post-marketing trial commitments.

I understand that Johnson & Johnson is exploring how to make all of this happen, as well as looking at other opportunities, but it isn't as easy as flipping a switch. Companies need to develop new systems, approaches and protocols -- all of which takes time. But for the sake of continued medical innovation and the continued enhancement of medical care, there is no doubt that taking steps to re-establish trust should be well worth the effort.

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