From
Dr. Alberto Tozzi
Innovation and patient engagement with Dr Alberto Tozzi
With Dr. Alberto Tozzi · hosted by Dr. David Cole
Chapter 1 of 7
Background
Introduction and Alberto Tozzi's Background
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
In the 1980s, being able to program a computer and use statistical software packages was extremely unusual in medicine.
It is very rare for an Italian hospital to have a Chief Innovation Officer position.
Bambino Gesù Hospital is owned by the Vatican, with the Pope as the ultimate authority.
During H1N1 pandemic preparedness, an experiment at Bambino Gesù used active RFID tags to track every person in the hospital to understand contact patterns.
Nurses are one of the categories most likely to spread infection in hospitals because they spend significant time with children and care for many patients.
Food distribution staff touch every single bed, making them important vectors for understanding infection spread patterns.
Measuring contact patterns and translating them into numbers is crucial for creating effective infection control policies.
Contact tracing apps are powerful tools, but you cannot contact trace people you don't know - this is a basic limitation.
Privacy concerns about contact tracing apps are much greater than healthcare professionals initially expected.
Bambino Gesù screens every patient and caregiver with questions, and performs lab diagnostic tests if there is any suspicion of COVID-19.
Northern Italian hospitals were unfortunate because they did not realize the new infection was coming and failed to limit contacts or screen patients.
Rome was more fortunate because virus circulation happened later, allowing time to set up screening systems.
New COVID-19 clusters in Rome came especially from people arriving from abroad, including from Bangladesh.
Speed is critical in outbreak response - once a single case is discovered, you must be as fast as possible in finding other cases.
Children do not appear to play a major role in driving COVID-19 infection transmission.
There is insufficient epidemiological information about COVID-19 in children, and a dedicated epidemiologic study is needed.
School closure may not have a major impact on COVID-19 circulation, which would be extremely important for allowing children to participate in community activities.
In 2-3 months, we will discover new therapies and be even more ready to handle COVID-19 than we are now, progressing until a vaccine is available.
Skepticism exists in hospitals about the possibility that disciplines different from medicine can help improve children's and patients' health.
Medical education traditionally consists only of medicine with no exposure to other disciplines, and because it is heavy and long, doctors feel it should be the highest profile possible.
Exploring other disciplines provides different points of view and reveals that you can learn even more than you did in medical training alone.
After attending an artificial intelligence in medicine conference with mostly data scientists and engineers, Tozzi realized he had to start studying things in a different way to remain at the same level.
People with long, consolidated careers are reluctant to go back and learn something new again.
The healthcare system lacks room for innovation and does not provide adequate investments, with confusion between innovation and research.
Everyone is enthusiastic about research, but nobody cares about innovation, despite a strong link between the two.
The system outside hospitals does not care about innovation, forcing innovators to translate innovation activities into research to access available funding and support.
Bambino Gesù's innovation group includes writers, data scientists, journalists, architects, nurses, and medical doctors - this diversity of profiles convinced people the group deserved attention.
Working in innovation with children provides a big advantage because children have fresh ideas and come up with solutions adults never think about.
Innovation is simply trying to find a solution to a problem when that solution does not exist yet.
The Science Shops project is a collaborative effort with hospitals in Barcelona (San Juan de Deo), Helsinki, and Toronto (Sick Children), pending European Commission funding.
The Science Shops project focuses on rare diseases because patients have several complex problems not yet addressed, including practical daily life issues beyond therapies.
Science Shops would be divided into three fields: innovation (inventing new devices), therapy (involving patients in clinical trial design), and service design (improving access to health structures and patient journey).
Science Shops would not only listen to patient-proposed issues but also select some and develop solutions within 6 to 12 months.
If successful, every hospital should have an infrastructure like Science Shops where patients can find someone who listens and helps make something real together with them.
Science Shops would involve patients by providing educational activities and bringing them on board to set up new solutions, not just having researchers work on innovation separately.
Rare disease patients face barriers to participation including disabilities that prevent leaving home, and COVID-19 adds additional connection barriers.
Virtual solutions and web connections can overcome participation barriers, and COVID-19 has created one of the biggest digital experiments in the world.
Rare disease patient associations are extremely active with strong backgrounds in participating in research and innovation and connecting with hospitals.
The Federation of Rare Diseases patient associations represents many people, and rare diseases collectively present many issues to address beyond single vertical approaches.
Virtualizing connections between associations, patients, and large hospitals will help bring innovations and approaches to local, smaller hospital settings.
The Science Shops application was submitted under citizen science, which is unusual for medical science but appropriate because participation is the key word.
Healthcare professionals consistently fail to recognize the power of patients and their families to make a difference.
SpaceX took less than one day to bring two people to a space station, making it similar to an air flight.
In 20 or 30 years, families may be living in space, and children will be subjects with significant health problems.
Children traveling to space would be exposed to radiation and physical forces that might be problematic for their health because they are very young.
Rather than declaring children should not travel to space, we should study whether they can do so in the future and what effects to expect.
It is completely unethical to make experiments on children in space; current knowledge comes only from animal models.
Laboratory experiments growing cells can be useful to understand what a child might suffer from space travel.
Artificial intelligence could be used to virtualize a model resembling a child to understand what happens if they travel to space.
Several technologies have had problems with ethics because ethical considerations were not addressed at the beginning.
Space travel presents an opportunity to think about technology and ethics simultaneously from the beginning, which is crucial and important.
Pediatricians should be involved in studying space travel effects on children because they take care of children's health and can address many issues, working alongside other disciplines.
This is the right time to put together ethics and technology for pediatric space medicine before it is too late and progress is conducted in the wrong way.
Healthcare remains very paternalistic; asking 'what do you think about that?' is different from directly involving families, caregivers, and children.
Children, families, and caregivers can give significant support because they know their disease and have fresh minds.