Communicative prescription for Russian medicine

Clinics, universities, manufacturers of pharmaceuticals and medical equipment cannot single-handedly respond to the grand challenges in the healthcare sector, so they are joining forces.

Cooperation becomes a critical factor in developing new drugs and medical technologies, and improving treatment techniques. Clusters offer an effective way to establish and maintain cooperation between clinics, manufacturing, research, and educational organisations operating in the field of medicine, authorities, and development institutions. Experts from the Higher School of Economics and the International Medical Cluster Foundation summarised the international experience in using this format, and suggested guidelines for applying it in Russia. Their joint report “The World’s Biomedical Clusters: Success Factors, and Stories of the Best” was presented on 3 April at HSE and commanded great attention of the expert community: during the discussion the audience showed an obvious interest in optimising communications in the healthcare sector.

See full text of the report “The World’s Biomedical Clusters: Success Factors, and Stories of the Best”, watch a video of its presentation, and see photos of participants.

Cluster policy-related issues have been studied at the Higher School of Economics for more than 10 years. Presenting relevant key projects, Leonid Gokhberg, HSE First Vice Rector and Director of the Institute for Statistical Studies and Economics of Knowledge (ISSEK), quoted data from the Russian Cluster Map. This interactive database maintained by the ISSEK Russian Cluster Observatory now includes profiles of more than 20 clusters specialising in medicine, pharmaceutics and related fields. One of the largest is the International Medical Cluster (IMC) which is being established in Moscow on the basis of the Skolkovo Centre.

Biomedical age is coming to replace the era of hydrocarbons

“People often ask, “What are you building all this for?” Hopefully in 10 years’ time nobody will be asking this question”, said Mikhail Yugai, General Director of the IMC Foundation. “The time of hydrocarbons-based economy is up, so everything that happens to us from now on will be largely based on biotechnology and biomedicine”. This domain is developing across the national borders, so one of the IMC’s main objectives is bringing Russian clinical practices, medical education, and research up to the global level. The cluster team intends to proceed towards this goal at an accelerated pace, without repeating mistakes of the others”.

Global frame of reference for biomedical clusters

To map the optimal development path, the IMC jointly with HSE conducted a benchmarking study of best international practices. Using the TCI Network, the European Cluster Cooperation platform, and the European Cluster Observatory databases, the authors of the study selected 40 clusters in 22 countries – leaders in medical tourism or healthcare, structured the approaches these clusters employed, identified common success factors, and  compared them with the IMC activities. The study included desk research, case studies, and interviews with managers of international clusters. Evgeniy Kutsenko, Head of the ISSEK Russian Cluster Observatory, presented the results.

Bringing together various players pursuing specific agendas in the scope of a cluster produces multiple positive effects. Patients get a new level, and a higher quality of service due to the integration of medical, insurance, tourist, and financial services; businesses get new start-ups. R&D organisations, due to international recruiting of research personnel, access to shared infrastructure, clinical databases, and advanced equipment increase the quality of their results, and speed up their application in end products. The whole healthcare system wins, due to integrated provision of services, emergence of new products, increased service standards, and improved personnel qualifications.

Faina Filina, the IMC Communications Director, noted that the cluster was actively strengthening members’ collaboration: hosting various events, organising foresight sessions, setting up discussion clubs where the medical community could address relevant to the industry topics. There are plans to establish an information portal about medical innovations, and teach basic patient literacy to the public. The cluster is supported by both regional and national authorities: the Moscow City Government co-finances the construction of pilot facilities, its representatives are members of the Supervisory Board – the cluster’s highest management body headed by the capital city’s mayor. On the federal level a law was passed which grants a special status to the cluster, namely allows to bring in leading international clinics and doctors, provide medical services in line with the OECD standards using cutting-edge drugs and medical products. One of the IMC’s objectives is to facilitate interconnections between three basic components: medical services, education, and research, i.e. the transfer of R&D results into clinical practices and training doctors to new specialities. “In the course of the study we realised that the IMC matches the best international practices, and all major success factors of global biomedical clusters. We see our contribution in attracting leading international clinics (just tomorrow we’re signing a membership agreement with the French company Clinea, part of the ORPEA Group), and offering international career and training opportunities to Russian doctors, thus keeping them in the national healthcare system. The IMC’s role is to speed up the transition to medicine of the future on the basis of experience and knowledge accumulated in the country”, summarised Faina Filina.

7 secrets of best medical clusters

Three types of clusters are described in the report (depending on their main specialisation area: high-tech medicine, biomedical research, or international medical tourism), and four goal models on which members’ cooperation is based (coordinating regional players’ activities; creating conditions for technology transfer from R&D organisations to businesses; bringing partners together in a global network; and common provision of services).

Despite varying practices adopted by biomedical clusters, the case studies revealed both common patterns, and unique paths to success. The authors of the study identified the following success factors:

Communication is essential for clusters. Cooperation develops in various ways: some clusters believe in “the digital” and offer members all sorts of platform solutions to step up cooperation, while others are convinced nothing is more important than personal contact.

Interdisciplinarity: biomedical clusters comprise healthcare and pharmaceutical organisations, medical equipment manufacturers, entrepreneurs, and doctors’ and patients’ communities who join forces to create high-technology products and services demanded by users.

Partnership-based management: some clusters may bring together different regions; e.g. in Germany the HealthCapital cluster comprises the Berlin and Brandenburg regions, and is managed by two executives.

Support by regional authorities: clusters are established for decades to come, so the region should be quite clear whether it wants a cluster or not. At the early stages the region’s contribution to cluster funding can be as high as 90%.

National-level recognition: it’s also important to have support by central authorities, since healthcare is regulated on the highest level.

Involvement of doctors and patients: initially clusters served as a bridge between R&D and business organisations; then they started to involve the population in various ways, in particular by promoting user innovation and setting up live labs.

Integrated infrastructural support: e.g. a bridge between Denmark and Sweden significantly contributed to the emergence of the Medicon Valley Alliance cluster. On the other hand, without the cluster the traffic going over the bridge would be much lighter.

Feedback from the book’s characters

Representatives of the three international clusters whose successful experience was presented in the report took part in discussing it via Skype.

Petter Hartman, General Director of the Medicon Valley Alliance (Denmark-Sweden) believed the study was useful for his team because it described, in a structured way, the key aspects of the cluster’s development to which managers should periodically go back. A future objective is to balance competition and cooperation in the cluster. “We’ve managed to organise interaction between companies, R&D centres, and universities in the areas covered by the Medicon Valley; now we must convince the central governments in Stockholm and Copenhagen that cooperation of Danish and Swedish members doesn’t threaten either country’s national interests, but would help strengthen the transboundary Øresund region”, noted the expert.

Caroline Simoes-Auberger, Strategic Development and Communication Manager of the French Eurasanté cluster, appreciated the study in terms of extending the pool of potential partners, and the opportunity to compare their organisation with biomedical clusters in other countries. She also shared her plans to step up cooperation in the cluster: “Over the previous few years we’ve been broadening the focus of our activities from supporting innovation in healthcare at the junction of academia and production to also involving end users, i.e. doctors and patients. We are helping mid-level medical personnel implement their ideas on improving clinical procedures, by holding innovative ideas competitions. And we involve patients in assessing businesses’ innovations because they know what can really make life in hospitals better”.

Kai-Uwe Bindseil, the HealthCapital cluster manager, was impressed with the study results. “The measure of our cluster’s success is the members’ joint projects”, stressed the German speaker. “Now we focus on the educational aspect, and support projects aimed at corporate training of workers who already have basic education in the medical technologies field. This is an answer to a current challenge: due to reduction of the population we are experiencing a shortage of young workers. Therefore we invest in training mature professionals, to bring their skills in line with the current technology development level”.

Demand for efficient communication

Sergei Petrikov, Director of the N.V. Sklifosovsky Emergency Medicine Research Institute believes that the IMC project “creates competition in the environment which is not really accustomed to competition”. In particular, the cluster may introduce new educational practices, contribute to raising the level of service by adopting best international standards, including in communication. And the communication aspect is particularly hard to improve: “We are losing to our foreign colleagues in terms of being client-oriented, in the quality of service and intra-hospital logistics. Russian patients are strong but even they are not always up to that kind of communication”, noted Sergei Petrikov. The Sklifosovsky Institute developed a staff retraining programme on patient relations.

Anatoly Sotnikov, General Director of the Kaluga Regional Innovation Development Agency – Cluster Development Centre, pointed out the ”new meanings” in the study, which could translate into new activity areas for the Kaluga pharmaceutical cluster, one of the first in Russia. He shared his plans to establish inter-industry collaboration to promote nuclear medicine development on the basis of the Obninsk facilities, confirming the premise of medicine being a major driver of economic growth.

Sergei Rumiantsev, Vice Rector (Strategic Development) at the Pirogov Medical University, supported the idea of a cluster: “There’s no way to set up a single institution with the full range of top-level competences, so we should sensibly distribute them, and then cooperate”. Vadim Tarasov, Director of the Institute of Translational Medicine and Biotechnology, Head of Pharmacology Department at the I.M. Sechenov University suggested that the IMC team should develop a map of technology-related competences by structuring experience of various organisations specialising in healthcare in the Moscow region; design and test advanced regulatory solutions in the cluster; and help members develop products which would match the requirements of the compulsory medical insurance system, and the public procurement rules.

Mikhail Goland, VEB Vice President (Innovation) promised to support the cluster’s projects, in particular with soft loans, and announced the signing of an agreement with the Moscow City government on the development of Moscow’s innovation infrastructure during the SPIEF.

Dmitri Kolobov, Director of the Russian Ministry of Industry and Trade’s Department for Development of the Socially Significant Products Industry, believed the cluster could turn into a “product showcase” for international professionals who come to Skolkovo to work or for on-the-job training. He also thought involving consumers in testing innovative products, and receiving feedback from them was extremely important. Dmitri referred to the Development Strategy for the Rehabilitation Industry which specifically requires to involve consumers in developing rehabilitation equipment. Just in Russia about 60 million people need it – people with disabilities, post-operation patients, and the elderly.

According to Ekaterina Kakorina, Professor at the Sechenov University and Director (Research) of the Personified Medicine Development Foundation, the biomedical cluster format and the IMC experience should be replicated in other regions, in particular the Far East, North Caucasus, and Khanty-Mansi Autonomous Region.

Larisa Popovich, Director of the HSE Institute for Health Economics, suggested the cluster team should make an effort to promote its image, and clearly understand what their main values are: “What the cluster is offering, including to the local community?” The cluster should also integrate into the national projects, otherwise it would be harder for it to grow.

The meeting moderator Leonid Gokhberg, HSE First Vice Rector and ISSEK Director, saw the cluster as an “assembly platform for advances of the Russian science, industry, and education”. How to identify them, was a matter for another discussion.

The cluster’s agenda will be the focus of debates in the scope of the “Prospects for creating “a territory of innovation” and promoting S&T breakthroughs in the EAEU” session scheduled for 12 April in the framework of the HSE April Conference, and of the expert session “Moscow innovative cluster: priority S&T development areas” which will take place on 24 April.