Battling disease

Why wildlife conservation is good for our collective health

From providing lifesaving drugs to buffering humans from disease, protection of wildlife habitat is key to human well-being.

What if we could reduce diseases and discover life-saving drugs by conserving natural habitat? Would saving ecosystems become more appealing if human health were on the line?

Well, although an underreported dimension of the destruction of wildlife habitat, human health is exactly what is at stake. Habitat destruction has played a role in the emergence of disease organisms that move between humans and other animals, such as Ebola, and even, some scientists argue, in the increase of incidences of Lyme disease. Loss of habitat has also had the unintended consequence of eliminating access to potentially lifesaving drugs by destroying the very places where those drugs originate.

Whether or not people care about nature for its own sake, these implications for human well-being should galvanise them toward habitat and wildlife conservation, and elevate conservation to the same level of importance as things such as cancer or stem cell research or efforts to eradicate malaria or HIV.

Disease emergence

Undisturbed, wild animals and their habitats can serve as a barrier preventing the spillover of emerging infectious diseases – EIDs – from animals to humans. Because the diseases and the animals have evolved together, the diseases have little to no effect on those animals. When transmitted to humans, however, those pathogens can result in EIDs. It has been estimated that 60% of recent EIDs have been zoonoses, and close to three-quarters of these originated in wildlife. The clearing of undisturbed habitat to pave way for human activities such as agriculture has created blurred boundaries between wild and domestic animals, helping to facilitate the jump to humans.

This is what happened in the cases of Nipah and Hendra viruses, among others. The clearing of forests in Southeast Asia and Australia, respectively, led certain types of flying fox fruit bats to move closer to farm animals (pigs in the case of Nipah; horses in the case of Hendra). The farm animals ate virus-ridden bat saliva or urine, became ill, and transmitted the disease to humans who came into contact with them. Neither virus was new, but both were kept from humans until habitat destruction facilitated the jump.

Zoonotic diseases exact an enormous human toll – identified diseases account for at least 2.7 million deaths and 2.5 billion cases of human sickness annually. In the developing world, zoonotic EIDs can exacerbate other public health challenges, such as lack of infrastructure and malnutrition resulting in increased bushmeat consumption, which can in turn introduce new varieties of EIDs. And zoonotic EIDs can have huge economic and social implications as well, such as loss of employment and business – familiar outcomes during outbreaks. For example, pig farmers in Malaysia incurred a loss of $244 million during a Nipah outbreak in 1998 and 1999 due to mass culling of pigs.

Almost half of human medicines come directly or indirectly from the natural world, even as less than 10 percent of all of the world’s biodiversity has been evaluated for potential drugs.

Surveillance, detection and responses to these outbreaks are unfortunately low in developing countries, which are often particularly vulnerable to the emergence of EIDs due to their proximity to areas of high biodiversity. As they develop, those countries and their people face higher exposure to zoonotic pathogens. Meanwhile, population density and increased global travel means transmission of these diseases will be effective, even in the developed world.

The tremendous harm zoonotic EIDs wreak globally points to a powerful need to improve our understanding of the role of wildlife ecology and the wildlife-livestock interface in their emergence. Increasing research in this area would offer tremendous benefit by improving our ability to predict which regions are most at risk and to prepare and respond to these threats. The recent surges in EIDs across the world underscore the importance of protecting wildlife habitat, both with speed and in scale.

Nature’s medicine

And then there’s medication: Almost half of human medicines come directly or indirectly from the natural world, even as less than 10% of all of the world’s biodiversity has been evaluated for potential drugs. Many lifesaving drugs, including some recent anti-cancer drugs, have originated in nature.

Yet all of this progress is likely just scratching the surface of nature’s incredible potential to yield health-promoting substances. New species are continually being found. Discoveries of bacteria that survive in the unlikeliest of places have opened possibilities for even more new drug discoveries. And scientists have recently begun tapping into potential drug discoveries from other members of the microbial world, too.

Meanwhile, 60% of people worldwide depend almost exclusively on plants for their primary medication. Animals are also used in parts of the developing world for traditional medicines. Yet, we are allowing the natural world to disappear without fully understanding what will be lost – or knowing at all, since we can only assume that some species are becoming extinct before humans even know about them. To protect these current and future sources of medicines, we need to protect the nature that provides them.

Studying and conserving nature is as important as any other human health initiative, and the health benefits of conservation need to be included alongside other discussions about saving nature. It is time to make the case that wildlife science and conservation are relevant to everyone’s life. Too many people’s health will be in jeopardy if we don’t.

Rashmi Bhat is a wildlife researcher in and participant in the Ensia Mentor Program. This article was first published in Ensia.

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What hospitals can do to drive entrepreneurship and enhance patient experience

Hospitals can perform better by partnering with entrepreneurs and encouraging a culture of intrapreneurship focused on customer centricity.

At the Emory University Hospital in Atlanta, visitors don’t have to worry about navigating their way across the complex hospital premises. All they need to do is download wayfinding tools from the installed digital signage onto their smartphone and get step by step directions. Other hospitals have digital signage in surgical waiting rooms that share surgery updates with the anxious families waiting outside, or offer general information to visitors in waiting rooms. Many others use digital registration tools to reduce check-in time or have Smart TVs in patient rooms that serve educational and anxiety alleviating content.

Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.

At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.

Getting the best from collaborations

Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”

Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

  • Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.