Fiona Wood says if she did not ask questions and challenge the system she wouldn’t be in her position today. Photos: Attila Csaszar

Entrepreneurialism needed within an evolving system

Tuesday, 28 November, 2017 - 15:38

Funding is the biggest issue within the healthcare sector and is the one thing that keeps burns surgeon Fiona Wood awake at night, attendees at a Business News Success & Leadership breakfast heard this morning.

The 2005 Australian of the Year said entrepreneurialism and the tenacity to challenge the status quo were qualities that health professionals needed to bring into their mix.

“I’d like to see a system where we have clinicians pitch the hardest thing they deal with every day and come back and get the scientists and the digital innovation teams, and then three months, six months or six weeks later have the solutions pitched and start to have that interdisciplinary conversation,” Professor Wood said.

The approach Professor Wood is advocating is the same as that adopted last week by Fiona Stanley Hospital at its 'data hack', an event that brought clinicians, entrepreneurs, software developers, and designers together to develop solutions to challenges facing the public health sector.

“Clinical, biomedical, or any problem is better solved with multiple heads, multiple lenses,” Professor Wood said.

"Diversity brings different lenses to the problem and then you can brainstorm and look for solutions.

“The other thing that is very important for budding people with ideas is when somebody says 'no', you don’t have to believe them.”

Professor Wood recommended persistence and locating a collaborative partner who won’t simply be a 'yes man', but will aid the problem solving process.

“(Saying) 'no’ without engagement in problem solving is a black hole to avoid,” she said.

“If someone just goes ‘no you can’t do that’ (and I’d listened), I wouldn’t have gotten off the blocks in my first week in med school; in fact I wouldn’t have gone to med school.”

Professor Wood said policies were not valid reasons to accept ‘no’ in the first instance.

 

“Let’s go look at the policy and let's change it,” she said.

“Let’s understand what the policy was established for, and if it is valid we’ll build on it. If it is not valid we will remove it, but you don’t have to believe that that is the end game.”

When commercialising her innovative spray-on skin technology, now branded as ReCell, Professor Wood encountered a number of problems common for early-stage listed companies.

She said the idea was to raise capital to bring the product to market, to fund further research based on royalties.

To facilitate that process, Professor Wood led a backdoor ASX listing in 2002 under the name Clinical Cell Culture, now named Avita Medical.

“We backdoor listed, we were on the ASX, it was far too early and caused us enormous difficulties,” Professor Wood said.

“We were in a very, very vulnerable position after having had some angel investment; moving forward wasn’t quite as we’d expected or anticipated or hoped and our backs were against the wall.”

The challenges facing the company included its failure to secure regulatory approval from the US Food and Drug Administration, as had been expected, in 2006.

ASX-listed Avita is continuing to pursue commercial opportunities for the spray-on skin technology jointly developed by Professor Wood, with the company recently obtaining funding from the Armed Forces Institute of Regenerative Medicine for FDA trials.

Professor Wood was previously a director of the company, but has stepped down to focus solely on research.

She said individual patient outcomes needed to be a key component of research, as opposed to simply the production of clinical data.

“There are so many different pressures and levers and change as we’ve gone forward, bringing that patient to the centre has been a really important part of the movement more generally,” Professor Wood told the Success & Leadership audience.

She said while it was easy to burrow down rabbit holes, finding the right one required engagement with consumers and understanding what mattered to people, as well as understanding how big data and artificial intelligence could drive relevant research.

Professor Wood said a program had been developed using IBM’s Watson supercomputer to reduce thousands of potential research opportunities down to a handful, based on a series of questions.

“But we have to know if that question is fundamentally correct, and the question is, why do people who have burn injuries have lifelong consequences around inflammation, heart disease and cancer," she said.

“That is a fundamental question our patients want to know the answer to, and then we check that and we use the technology of tomorrow to answer it.”

To improve research and patient outcomes, Professor Wood said a reduction in the layers of bureaucracy was needed to create room for innovation.

“In the system we have today we have layers of governance built around the changes we have in society that are at a level of constraint I think needs questioning,” she said.

“The fact is we’ve got one bad apple in the box, so we make every other person do something because of the bad apple.

“With the advancing biotechnology and the advancing understanding of big data, with the understanding in that whole digital innovation space, let us actually go forward and work out where we can have a governance structure in health that facilitates innovation in a safe and secure way.” 

Professor Wood said the whole biotechnology space was rapidly evolving and needed to be extremely resource savvy.

“It’s an environment of health rationing, health budget constraints, and understanding that every decision we make as a health professional is a resource decision,” she said.

“And so we have to justify the introduction of new technologies in a very rigorous way and appropriately so; not just from a safety perspective, but also from a cost-effective perspective.”

Becoming strategic about management of the healthcare sector would provide opportunities to ensure the health system was sustainable into the future, Professor Wood told the forum.

“I spend a lot of time on the surgical planning side of things,” she said.

“One adult male leg will take 12 bandages; if you stand and wait for those 12 bandages to be opened, that takes 1.5 minutes.

"That doesn’t sound a lot, but if you translate that into theatre time you jack up the dollars, the clock is ticking.

“If you get them open before, you save 1.5 minutes; but if you open 18 bandages to save time just to be sure, then you waste six bandages worth of money.” 

She said this approach was effective in changing behaviours and conserving resources.

Professor Wood is also a mother of six and said she was the only woman to be working in plastic surgery in Perth for about a decade. 

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