Stanford’s Biodesign Innovation program: Teaching opportunities for value-driven innovation in surgery

Published:December 19, 2019DOI:


      The Stanford Biodesign Innovation process, which identifies meaningful clinical needs, develops solutions to meet those needs, and plans for subsequent implementation in clinical practice, is an effective training approach for new generations of healthcare innovators. Continued success of this process hinges on its evolution in response to changes in healthcare delivery and an ever-increasing demand for economically viable solutions. In this article, we provide perspective on opportunities for value-driven innovation in surgery and relate these to value-related teaching elements currently integrated in the Stanford Biodesign process.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Centers for Medicare & Medicaid Services
        NHE Fact Sheet; 2018.
        • Centers for Medicare & Medicaid Services
        National Health Care Spending in 2016; 2016.
        • Muñoz E.
        • Muñoz 3rd, W.
        • Wise L.
        National and surgical health care expenditures, 2005-2025.
        Ann Surg. 2010; 251: 195-200
        • Global Burden of Disease Health Financing Collaborator Network
        Future and potential spending on health 2015-40: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries.
        Lancet. 2017; 389: 2005-2030
        • Congressional Budget Office
        Technological change and the growth of health care spending; 2008.
        Date accessed: October 3, 2018
        • Roehrig C.S.
        • Rousseau D.M.
        The growth in cost per case explains far more of US health spending increases than rising disease prevalence.
        Health Aff (Millwood). 2011; 30: 1657-1663
        • Bradley R.
        The cost of care: new insights into healthcare spending growth. Beyond the Numbers. 2017;6. Washington DC: Bureau of Labor Statistics.
        (Available at:)
        • van Oostrom S.H.
        • Gijsen R.
        • Stirbu I.
        • et al.
        Time trends in prevalence of chronic diseases and multimorbidity not only due to aging: Data from general practices and health surveys.
        PLoS One. 2016; 11e0160264
        • Buttorff C.
        • Ruder T.
        • Bauman M.
        Multiple chronic conditions in the United States;2017. Santa Monica (CA): RAND Corporation.
        (Available at:)
        Date accessed: December 11, 2018
        • Phillips K.A.
        • Trosman J.R.
        • Deverka P.A.
        • et al.
        Insurance coverage for genomic tests.
        Science. 2018; 360: 278-279
        • Anderson G.F.
        • Hussey P.
        • Petrosyan V.
        It’s still the prices, stupid: Why the us spends so much on health care, and a tribute to Uwe Reinhardt.
        Health Aff (Millwood). 2019; 38: 87-95
        • Capps C.
        • Dranove D.
        • Ody C.
        The effect of hospital acquisitions of physician practices on prices and spending.
        J Health Econ. 2018; 59: 139-152
        • Cohen D.J.
        • Reynolds M.R.
        Interpreting the results of cost-effectiveness studies.
        J Am Coll Cardiol. 2008; 52: 2119-2126
        • Brouwer W.
        • van Baal P.
        • van Exel J.
        • Versteegh M.
        When is it too expensive? Cost-effectiveness thresholds and health care decision-making.
        Eur J Health Econ. 2018; 20: 175-180
        • Feeley B.T.
        • Liu S.
        • Garner A.M.
        • Zhang A.L.
        • Pietzsch J.B.
        The cost-effectiveness of meniscal repair versus partial meniscectomy: A model-based projection for the United States.
        Knee. 2016; 23: 674-680
        • Pietzsch J.B.
        • Garner A.M.
        • Marks W.J.
        Cost-effectiveness of deep brain stimulation for advanced Parkinson’s disease in the United States.
        Neuromodulation. 2016; 19: 689-697
        • Katsanos K.
        • Geisler B.P.
        • Garner A.M.
        • Zayed H.
        • Cleveland T.
        • Pietzsch J.B.
        Economic analysis of endovascular drug-eluting treatments for femoropopliteal artery disease in the UK.
        BMJ Open. 2016; 6e011245
        • Keating C.L.
        • Dixon J.B.
        • Moodie M.L.
        • et al.
        Cost-effectiveness of surgically induced weight loss for the management of type 2 diabetes: modelled lifetime analysis.
        Diabetes Care. 2009; 32: 567-574
      1. Yock P.G. Zenios S. Makower J. BIODESIGN: The Process of Innovating Medical Technologies. second ed. Cambridge University Press, Cambridge (UK)2015: 839
        • Watkins J.
        Need statements meet value propositions: internal presentation. Stanford Biodesign, Stanford, CAJanuary 12, 2018
        • Stanford Byers Center for Biodesign
        Biodesign Innovation Fellowship.
        (Available at:)
      2. Cohen M.S. Kao L.S. Success in Academic Surgery: Innovation and Entrepreneurship. Springer International Publishing, New York2019
        • Wall J.
        • Hellman E.
        • Denend L.
        • et al.
        The impact of postgraduate health technology innovation training: Outcomes of the Stanford Biodesign Fellowship.
        Ann Biomed Eng. 2017; 45: 1163-1171