Stanford Biodesign Fellow Sets Sights On Improving Healthcare In China

Dorothea Koh, an alumna of the Stanford Biodesign Innovation Fellowship

Dorothea Koh, an alumna of the Stanford Biodesign Innovation Fellowship, is working to improve safety and access to care at outpatient infusion clinics across China.

It’s no surprise that graduates of the Stanford Biodesign Innovation Fellowship are using their training in health technology innovation to launch start-ups that bring revolutionary products to patients in the United States and other countries with advanced healthcare systems. What’s less well known is that some graduates of the program are applying the biodesign innovation process to address the unmet medical needs of patients in countries striving to keep pace with the healthcare demands of their citizens. And perhaps even more unexpectedly, some are tackling these challenges by leading innovation from within large multi-national corporations. 

Dorothea Koh, who completed the Biodesign Innovation Fellowship in 2007-08, is one such graduate. Koh works for an international medtech company, where she manages a Shanghai-based team charged with creating and commercializing disruptive technologies tailored to the Chinese market.  Because of her training in the biodesign innovation process, Koh feels exceptionally well-prepared to spearhead this effort.

The biodesign innovation process is a unique, highly-disciplined methodology for identifying important unmet medical needs, developing innovative technologies to address them, and preparing to bring those solutions into patient care through start-up, corporate, or other channels. Because the process requires validating each step from the perspective of the stakeholders in their local healthcare environment, graduates of the program can apply it to uncover compelling medical needs, innovate, and successfully deliver solutions in any geographic or economic setting.

As Koh explains, “For a solution to meet a need, it has to work in the location where that need exists. When you’re identifying a need, you’re trained to immerse yourself in the physical and cultural environment and think about the problems you are observing from the perspective of the user. Then, when you’re inventing a solution to the need, the process forces you to carefully consider exactly how and where it will be used. When you’re ready to implement that solution, the process again requires you to examine everything from clinical practices to economics to infrastructure so you can successfully get it to patients. The very nature of the process shuts ideas down if they don’t take the resource setting and constraints into account.”

One of the first areas that Koh and her team investigated involved outpatient infusion centers. Describing an early visit, she recalls, “I had never seen so many people getting intravenous [IV] infusions all at once. It looked like a dialysis center, but instead of machines, it had row after row of IV poles.” Because IV treatment is preferred over oral medication, China is the world’s largest infusion market, with about 10 billion infusions given annually, or eight to 10 infusions per person, per year; five times greater than the world average. “You see people hooked to infusion bags everywhere, even young kids,” Koh notes.

“Our first step was to really spend time in the market and understand what the nurses and patients in the centers were doing as the status quo,” she says. Some of the major challenges she observed included the massive volume of patients, the speed required to serve them all, which often leads nurses to sacrifice their own safety in favor of efficiency, and issues related to cost and affordability that make it difficult for the centers to adopt and sustain best safety practices.

“Our goal became, how can we touch more infusions in China and make them safer for so many people that it leads to a healthier China?” Koh states. “But how do you bring healthcare to millions and millions of people? You can’t take solutions that were created for developed markets and bring them into an emerging one like China and expect them to work the same way. You have to develop innovation hubs with people who understand how to design and innovate for that context.”

Koh’s solution to the challenges she observed involves the development of the world’s first mobile compounding center, as well as other low-cost practices to improve the safety and efficiency of intravenous infusions for both patients and healthcare providers. As she and her team work to commercialize their new solution, they continue to look for other ways to improve healthcare across China and in other emerging markets. “Stanford Biodesign has taught me how to design and innovate anywhere. It has equipped me with the right set of tools and skills to meet the needs of any market, especially emerging ones,” she says.