The Management of Medical Innovations Using Propriety Technology: A Mexican Case Study

Article excerpt

Case of the development project of a biological tissue cut laser system for the cardiac bioprostheses at the Departamento de Biotécnica Aplicada del Instituto Nacional de Cardiología de México in collaboration with the Centro de Ciencias Aplicadas y Desarrollo Tecnológico (CCADET) de la Universidad Nacional Autónoma de México (UNAM). Case stresses the success of technological innovations in hospital, is not just a question of solving technical issues but management ones as well. The technology management issues involved in the innovation processes carried on by the parts were the development of proprietary technology and the project multiplication phenomena based in organizational learning interaction. Parts involved are doing innovations in the health sector looking to improve the cardiac Mexican patients' living standards.

Introduction

The Instituto Nacional de Cardiología (NCI) was founded in México City in 1944 by Dr. Ignacio Chavez, to treat and research on cardiac sickness. It is a non lucrative public institution attending basically low resources population. In 1970 several actions began of an auto sufficiency program looking to reduce its international market and technology dependence. The objective of one of the program projects was the development of cardiac valve bioprostheses which are needed to treat a great variety of valve pathologies. These cardiac valves are normally imported, therefore it is necessary to develop cardiac bioprostheses in Mexico for the following reasons: (a) the growing number of heart sicknesses in the population, (b) high importation costs, (c) reduce technological dependence.

The population of Mexico is about 110 million persons requiring an average of about 50,000 to 70,000 heart surgeries by year; nevertheless, it is estimated that in all nation hospitals including the INC, between 5,000 to 8,000 annual surgeries are realized, a third of them valve related. In general the infrastructure and the materials to perform open heart or minimum invasion surgeries comes from United States or Europe, for that reason each imported valve costs several thousand US dollars and some of them like the mechanical type can be used to correct valve problems but produce important secondary risk problems. One of these problems is the "turbulence" produced by mechanical valves that could develop fatal thrombosis and embolism, therefore patients with this type of valves will require the use of anticoagulant for life to reduce the risk of cerebral vascular problems. On the other side the biological bioprostheses tend to calcify because their biological tissues are prepared with glutaraldehide, a substance needed for the fixation and sterilization of the tissue to avoid a possible rejection of the xenoinjerto but on the other side attracts calcium molecules; for that reason almost always it is required to change the valve at a future time.

The Departamento de Biotécnica Applicada (DBA) of the INC was founded in 1983 and has more than two decades manufacturing cardiac valves. Since its creation has intensively participated in valve development and innovation projects; its technology strategy is focused in the improvement and innovation of their products in a continuous learning process promoted by their product social value. (Hughes & Chafin,1996). In such a way the INC's DBA had developed different projects with their own capacities obtaining some results as their own pericardium calcification prevention system. Figure 1 shows some prototypes of the cardiac bioprostheses actually under study of the INC.

To increment their capacities the INC promoted several collaboration agreements with different entities of the UNAM in order to develop some of the supporting technologies they required with the science and technology allied institutions. Partners obtained project financing from governmental programs.

Bovine pericardium valves

The bovine pericardium is a biological tissue used for many cardiology surgeries and is the raw material for the cardiac valve manufacturing. …