Disruptive Innovation and Policy in Healthcare (2025-2026)

Background

There is a fundamental concept creating barriers in disease prevention and control: the more advanced the treatment, the better the odds. The reality is often the opposite: the more advanced the treatment, the more inaccessible the care delivery pathway. The cost of advanced treatments create ripple effects that extend beyond the individual — to the family unit, the health care system and a country’s socioeconomic fabric.

Chronic disease presents a growing burden, particularly to those who live in low-income households, face discrimination or live in states that do not support their healthcare. Investing in simple but effective technologies can reduce structural and social barriers that limit access to care. So why have we not seen greater uptake of these transformative technologies? Obstacles include physician distrust of less-skilled care providers, expense and time required to change existing workflows, regulatory agency risk aversion and the lack of insurance for these novel, disruptive technologies. There is a need to develop and promote such innovations to help address barriers to healthcare.

Duke’s Center for Global Women’s Health Technologies (GWHT) develops disruptive innovations to address structural and social barriers to healthcare in low- and middle-income countries. They have deployed their technologies to improve access to early cervical cancer detection in Kenya and Peru. The goal of this project is to develop the knowledge base to promote adoption of the same technologies to address critical gaps in cervical cancer prevention in the U.S.

Project Description

GWHT has developed two disruptive innovations for their global cervical cancer prevention initiative. The Pocket Colposcope reduces structural barriers by shifting early detection from “physicians in urban centers” to “midwives in community settings.” Still, fear of the speculum and feelings of vulnerability deter women from gynecological exams. A sister technology called the Callascope allows women to privately perform self-imaging exams without a speculum, providing an unprecedented opportunity for cancer surveillance in a non-clinical setting. GWHT has collaborated with the former health minister of Peru to establish a technology-enabled, midwife-run see-and-treat program in 20 community clinics in the Andean city of Cajamarca in Peru. These clinics now see thousands of women — the vast majority of whom have never been screened before.

This project team aims to adapt the Pocket Colposcope and Calloscope to address local gaps that limit access to cervical cancer prevention in the U.S. Team members will review case studies where disruptive technologies successfully replaced entrenched solutions in lower-income countries. The team will then identify vulnerable patient communities and policy barriers in the U.S. and design a pilot study that targets populations most likely to benefit, builds trust in the technology, aligns financial interests where possible and complies with applicable regulations. Pilot studies will include an operation plan, marketing and launch strategy, key milestones and a realistic timeline. Finally, students will create and present pitches to “mock investors” who are faculty and entrepreneurs that have experience in raising capital and building startups in the device or software space.

Anticipated Outputs

A document to help maximize the benefit of these technologies to women at risk; a business plan for investment in the technology; an elevator pitch and slide deck that can be presented at business plan competitions

Student Opportunities

Ideally, this project team will include 3 graduate students and 6 undergraduate students. Interested students may have backgrounds in science and engineering, health policy and business.

Students will learn how technologies are implemented in a clinical context, while gaining insight into the value-add the stakeholders see in these technologies and how they can be best positioned for widespread use. Students will directly engage with patients, providers and program planners throughout the course of the project to gather and synthesize information on the pros and cons of different types of care delivery. They will carry this out in three different population settings — the Appalachian region of North Carolina, the plains (for example, Nebraska) and Alaska.

Team members will also gain technical skills, including qualitative data collection and analysis, policy brief composition and cost-efficacy evaluation. They will learn practical skills in making a case for investment through the creation of a business plan, pitch deck and presentation to experts. Graduate students will have the opportunity to develop leadership skills through mentoring undergraduates.

In Fall 2025, the team will meet on Tuesdays from 9-10 a.m.

This project will have three sub-teams: self-use of health technologies, primary-provider-based care and specialist-based care. Graduate students will serve as leaders of each sub-team, and two undergraduates will be paired with each graduate student. Teams will meet weekly, and the entire group will meet biweekly for topic-specific discussions.

All students will have the opportunity to travel to Asheville, N.C., Alaska and Nebraska during winter break 2025 or spring break 2026. Depending on the outcomes of the project during the fall and spring semesters, students may have an opportunity to further develop their business plans and attend pitch events during summer 2026.

Timing

Fall 2025 – Spring 2026

• Fall 2025: Attend lectures to learn background information; develop a document about maximizing the benefit of disruptive technologies; explore the applicable regulatory and payer policy challenges to introducing new care paradigms in the U.S.
• Spring 2026: Develop a business plan and elevator pitch for the use of disruptive technologies; travel to domestic locations to engage with stakeholders; present pitches to “mock investors”; refine business plans and pitches; receive support and training for participation in business plan competitions

Crediting

Academic credit available for fall and spring semesters

 

_{Image: Mercy Asiedu holds the Pocket Calloscope - a low-cost cervical cancer self-screening device developed by the Center for Global Women's Health Technologies at Duke}