Innovation

The Terasaki Institute occupies a unique place in the world of research institutions. We combine the rigor of academic research with the agility of private sector enterprises in a mission to translate our innovation into products that matter to patients. Our research platforms are interdisciplinary, and we practice “convergent science” which enables us to combine disciplines and platforms to solve often intractable and impactful problems with freedoms often difficult to achieve in academic institutions. For example, much of our work lays at the intersect of engineering and medicine, two areas that are rarely combined in normal academic institutions. This is reflected in the highly interdisciplinary nature of our faculty and our operating models devoid of “departments” and other silos. Many of these approaches are institutionalized in our leadership principles, which illustrate why the Terasaki Institute is not only a unique place to conduct research but also a particularly effective institution.

The ability to deliver on this potential however, hinges on our ability to not only develop the basic science, but also to apply it to patient-facing applications that deliver impacts. Often these applications require translational sponsorship that only private sector companies can provide, both from a funding perspective and from a clinical execution. Navigating the “gap” between laboratory research and patient-facing products is the role of the innovation team at the Terasaki Institute.

Without an effective innovation program, we are not likely to successfully deliver on the patient impacts that form our mission. Our innovation program strives to partner with faculty and the science team to ensure that the ultimate translation of discovery is part of every research project and often from the very beginning of a project. Accelerating such translation can save lives of our patients and so we strive to drive a sense of urgency in our work.

What research programs stands the best chance of successfully transitioning into innovation and ultimately successfully translate into products that make a difference? At the Terasaki Institute, we focus on balancing two key metrics to identify the programs that will deliver the highest potential for outcome – Risk and Impact (Fig. 1). This gives a semi-quantitative metric that combines technical risk for the innovation to successfully reach the clinic, or in other words the technical readiness of the discovery – and the impact that the resulting innovation will have in the world if successful. Risk is often a function of how early a discovery might be and what remains to be done, including any regulatory pathways for clinical use. The impact assessment is often more difficult to define – sometimes people focus on mortality metrics to stack rank a possible indication for innovation. However, health is much more complex than mortality alone.

	Fig 1. A visual representation of Risk vs. Impact in our innovation potential assessment. Increasing Risk at parity of impact might lead to excessive time and cost of innovation. Low impact and low risk might lead to opportunistic innovation that could be delivered quickly but is unlikely to change the world.

Every year of life when an individual is unable to live to their full potential because of sickness introduces a disability that needs to be part of the impact assessment. At the Institute, we measure impacts through a quantitative framework developed by the WHO (World Health Organization) called the Disability-Adjusted Life Years or DALY (Fig. 2). This measure can be calculated easily for most biomedical innovation and provides a framework for the assessment of the impact of a specific innovation in the context of an indication. Fig. 2 shows a composite of the DALY impact of every disease. You might be surprised to see impactful diseases that are not necessarily associated with the highest mortality.

	Fig 2. The global burden of disease measuring DALY impact of every major disease for the global population (Institute for Health, Metrics & Evaluation, University of Washington).

Historical practice suggests that the most successful innovations are those that deliver the highest DALY reduction at the lowest cost. This is fundamentally our innovation strategy. Based on these approaches, the Innovation team at the Terasaki institute has begun to curate high impact Grand Challenges that will help the research team define any unresolved biomedical problems that are most likely to matter the most within this impact space, while at the same time define the metrics of success for the resulting innovation. Our hope is that these Grand Challenges will help our scientists focus their research onto specific high impact problems that, when solved will have large chances for translation to patient and will deliver large impact in patient’s lives. Over time, we look forward to sharing with you some of these Grand Challenges and the resulting innovation from the Terasaki Institute.

Maurizio Vecchione