SlideShare ist ein Scribd-Unternehmen logo
1 von 30
Downloaden Sie, um offline zu lesen
Scaling Innovation in Academic Medical Centers
Maulik D. Majmudar, MD
Healthcare Transformation Lab
Massachusetts General Hospital
Partners Healthcare
@mdmajmudar
Chronic Disease Burden
Adults Deaths
70%
50%
Rising Healthcare Costs
Rising Healthcare Costs
Poor Healthcare Quality
Poor Healthcare Quality
EPISODIC
REACTIONARY
PROVIDER CENTRIC
HIGH VOLUME
NON-TRANSPARENT
INACCESSIBLE
Medical Practice
TODAY FUTURE
EPISODIC
REACTIONARY
PROVIDER CENTRIC
HIGH VOLUME
NON-TRANSPARENT
INACCESSIBLE
Medical Practice
TODAY FUTURE
CONTINUOUS
PROACTIVE
PATIENT CENTRIC
HIGH VALUE
TRANSPARENT
ACCESSIBLE
EPISODIC
REACTIONARY
PROVIDER CENTRIC
HIGH VOLUME
NON-TRANSPARENT
INACCESSIBLE
Medical Practice
TODAY FUTURE
CONTINUOUS
PROACTIVE
PATIENT CENTRIC
HIGH VALUE
TRANSPARENT
ACCESSIBLE
EPISODIC
REACTIONARY
PROVIDER CENTRIC
HIGH VOLUME
NON-TRANSPARENT
INACCESSIBLE
Medical Practice
TODAY FUTURE
1. Affordable Care Act
2. Technological
advances
3. Consumer demand
How do we get there?
Innovation is everywhere…
So why aren’t we seeing rapid transformation
of healthcare delivery in academic medical
centers?
Implementation Barriers
Low
engagement
Innovating in
silos
Competing
priorities
Misaligned
incentives
Fear of
failure
๏ Product
๏ Evidence base for safety and effectiveness
๏ Clinical workflow integration at scale
๏ Program
๏ Programmatic bandwidth for pilots (competing priorities)
๏ Clinical bandwidth for pilots
๏ Price
๏ Overall budget (operating and capital expenses)
๏ ROI (clear value proposition)
Barriers to Scaling Innovation
CONSUMER versus PATIENT
ADAPTED FROM KRISHNA YESHWANT; HXREFACTORED 2015
Medical complexity
Socialcomplexity
CHRONIC DISEASE
PATIENTS
CONSUMERS OF
DIGITAL HEALTH
SOLUTIONS
To improve the experience and value of
healthcare through collaborative innovation
Mission
Engage
Goals
Connect Support Catalyze
An open innovation contest that taps into the collective
knowledge, experience, and creativity of our staff to
transform healthcare
Ether Dome Challenge
235
submissions
> 50
innovators
>200 crowd
voters
6 grants
awarded
Feedback from the Frontline
Enables bottoms-up
innovation
Systemizes frontline
ideas generation
Promotes a sense of
community
Creates a sense of
ownership/
engagement
Facilitates
organizational
exchange of ideas
Spreads innovative
thinking
Promoting Collaboration
Co.Create
๏ A co-development program between MGH, MIT, and MassChallenge
๏ Unprecedented access to MGH clinicians and staff
๏ Rich mentorship ecosystem
๏ Pilot funding for teams
๏ Engage with front line providers to understand their pain points
๏ Engage with executive leadership to identify strategic priorities
๏ Examples of key priorities:
๏ Improving access to care
๏ Reducing hospital readmissions
๏ Improving patient experience
๏ Reducing administrative burden for providers
Aligning Incentives
Risk Averse to Risk Tolerant
Healthcare
Transformation
Lab
Heart Center
MGH/PO
Leadership
Partners Healthcare
Dedicated Innovation Team
๏ First step towards transforming outpatient specialty care through
technology
๏ Experimenting with different business and care models
Example 1
TeleHeart
๏ A new care model that leverages technology to enable frequent
asynchronous ‘micro-visits’ and remote monitoring
Example 2
Digital Health Practice
๏ Cloud-based image sharing
๏ Wayfinding software application
๏ Secure text messaging
๏ Referral management and patient-provider matching
Other Examples
Key Requirements for Scaling Innovation
Collaboration
Alignment of
Incentives
Risk Tolerance Long-term vision
Clear Value
Proposition
Maulik D. Majmudar, MD
Associate Director, Healthcare Transformation Lab
Cardiologist, Massachusetts General Hospital
Email: mmajmudar@partners.org
Twitter: @mdmajmudar
Most of us understand innovation is important.
It’s the only insurance against irrelevance.
- Gary Hamel
I have not failed. I’ve just found 10,000 ways that don’t work.
- Thomas Edison

Weitere ähnliche Inhalte

Was ist angesagt?

Society for the Prevention of Uneducated Physicians
Society for the Prevention of Uneducated PhysiciansSociety for the Prevention of Uneducated Physicians
Society for the Prevention of Uneducated Physiciansguestbf9e39
 
Behavioural change presentation from Mobile World Congress 2016
Behavioural change presentation from Mobile World Congress 2016Behavioural change presentation from Mobile World Congress 2016
Behavioural change presentation from Mobile World Congress 2016Ross Taylor
 
Astute doctor 2015.03_product overview
Astute doctor 2015.03_product overviewAstute doctor 2015.03_product overview
Astute doctor 2015.03_product overviewGrant Simic
 
Mayo Clinic- Business Model by Rushabh Menon
Mayo Clinic- Business Model by Rushabh MenonMayo Clinic- Business Model by Rushabh Menon
Mayo Clinic- Business Model by Rushabh MenonRushabh Menon
 
David tyas - telehealth evaluation view from the frontline-021012
David tyas - telehealth evaluation view from the frontline-021012David tyas - telehealth evaluation view from the frontline-021012
David tyas - telehealth evaluation view from the frontline-021012Nuffield Trust
 
Delivering the Five Year Forward View: Working collaboratively to prevent stroke
Delivering the Five Year Forward View: Working collaboratively to prevent strokeDelivering the Five Year Forward View: Working collaboratively to prevent stroke
Delivering the Five Year Forward View: Working collaboratively to prevent strokeHealth and Care Innovation Expo
 
Using Cognitive task analysis to understand the decision making process for p...
Using Cognitive task analysis to understand the decision making process for p...Using Cognitive task analysis to understand the decision making process for p...
Using Cognitive task analysis to understand the decision making process for p...INSPIRE_Network
 
Improving the Quality of Care in General Practice
Improving the Quality of Care in General PracticeImproving the Quality of Care in General Practice
Improving the Quality of Care in General PracticeThe King's Fund
 
eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009William Mencia, MD, CCMEP
 
Health IT Summit San Francisco 2015 - Keynote Presentation "Tesla or Google? ...
Health IT Summit San Francisco 2015 - Keynote Presentation "Tesla or Google? ...Health IT Summit San Francisco 2015 - Keynote Presentation "Tesla or Google? ...
Health IT Summit San Francisco 2015 - Keynote Presentation "Tesla or Google? ...Health IT Conference – iHT2
 
Finding Actionable Insights from Healthcare's Big Data
Finding Actionable Insights from Healthcare's Big DataFinding Actionable Insights from Healthcare's Big Data
Finding Actionable Insights from Healthcare's Big DataMedullan
 
Digital Medicine Acceleration: The Promise of Learning Health Systems
Digital Medicine Acceleration: The Promise of Learning Health SystemsDigital Medicine Acceleration: The Promise of Learning Health Systems
Digital Medicine Acceleration: The Promise of Learning Health SystemsMedullan
 
WASHINGTON DC CONFERENCE EVALAUTION SUMMARY How to Achieve High Reliability w...
WASHINGTON DC CONFERENCE EVALAUTION SUMMARY How to Achieve High Reliability w...WASHINGTON DC CONFERENCE EVALAUTION SUMMARY How to Achieve High Reliability w...
WASHINGTON DC CONFERENCE EVALAUTION SUMMARY How to Achieve High Reliability w...Stephanie Dougherty
 
Daniel Jackson, UCB
Daniel Jackson, UCBDaniel Jackson, UCB
Daniel Jackson, UCBGoPrezi
 
Precepting a whole new world poster 2015 final
Precepting a whole new world  poster 2015 finalPrecepting a whole new world  poster 2015 final
Precepting a whole new world poster 2015 finalEmily Sermersheim
 
Carolyn Der Vartanian, (former) Clinical Excellence Commission
Carolyn Der Vartanian, (former) Clinical Excellence CommissionCarolyn Der Vartanian, (former) Clinical Excellence Commission
Carolyn Der Vartanian, (former) Clinical Excellence CommissionSax Institute
 

Was ist angesagt? (20)

Society for the Prevention of Uneducated Physicians
Society for the Prevention of Uneducated PhysiciansSociety for the Prevention of Uneducated Physicians
Society for the Prevention of Uneducated Physicians
 
Behavioural change presentation from Mobile World Congress 2016
Behavioural change presentation from Mobile World Congress 2016Behavioural change presentation from Mobile World Congress 2016
Behavioural change presentation from Mobile World Congress 2016
 
Astute doctor 2015.03_product overview
Astute doctor 2015.03_product overviewAstute doctor 2015.03_product overview
Astute doctor 2015.03_product overview
 
Mayo Clinic- Business Model by Rushabh Menon
Mayo Clinic- Business Model by Rushabh MenonMayo Clinic- Business Model by Rushabh Menon
Mayo Clinic- Business Model by Rushabh Menon
 
David tyas - telehealth evaluation view from the frontline-021012
David tyas - telehealth evaluation view from the frontline-021012David tyas - telehealth evaluation view from the frontline-021012
David tyas - telehealth evaluation view from the frontline-021012
 
Delivering the Five Year Forward View: Working collaboratively to prevent stroke
Delivering the Five Year Forward View: Working collaboratively to prevent strokeDelivering the Five Year Forward View: Working collaboratively to prevent stroke
Delivering the Five Year Forward View: Working collaboratively to prevent stroke
 
Using Cognitive task analysis to understand the decision making process for p...
Using Cognitive task analysis to understand the decision making process for p...Using Cognitive task analysis to understand the decision making process for p...
Using Cognitive task analysis to understand the decision making process for p...
 
Implementing the Vincent Framework at the Frontline
Implementing the Vincent Framework at the FrontlineImplementing the Vincent Framework at the Frontline
Implementing the Vincent Framework at the Frontline
 
Improving the Quality of Care in General Practice
Improving the Quality of Care in General PracticeImproving the Quality of Care in General Practice
Improving the Quality of Care in General Practice
 
eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009
 
Dr Julia Reynolds - ECO 21
Dr Julia Reynolds - ECO 21Dr Julia Reynolds - ECO 21
Dr Julia Reynolds - ECO 21
 
Health IT Summit San Francisco 2015 - Keynote Presentation "Tesla or Google? ...
Health IT Summit San Francisco 2015 - Keynote Presentation "Tesla or Google? ...Health IT Summit San Francisco 2015 - Keynote Presentation "Tesla or Google? ...
Health IT Summit San Francisco 2015 - Keynote Presentation "Tesla or Google? ...
 
Finding Actionable Insights from Healthcare's Big Data
Finding Actionable Insights from Healthcare's Big DataFinding Actionable Insights from Healthcare's Big Data
Finding Actionable Insights from Healthcare's Big Data
 
Digital Medicine Acceleration: The Promise of Learning Health Systems
Digital Medicine Acceleration: The Promise of Learning Health SystemsDigital Medicine Acceleration: The Promise of Learning Health Systems
Digital Medicine Acceleration: The Promise of Learning Health Systems
 
"Patient-Centeredness and Patient Safety: How Are They Interconnected?" Don B...
"Patient-Centeredness and Patient Safety: How Are They Interconnected?" Don B..."Patient-Centeredness and Patient Safety: How Are They Interconnected?" Don B...
"Patient-Centeredness and Patient Safety: How Are They Interconnected?" Don B...
 
WASHINGTON DC CONFERENCE EVALAUTION SUMMARY How to Achieve High Reliability w...
WASHINGTON DC CONFERENCE EVALAUTION SUMMARY How to Achieve High Reliability w...WASHINGTON DC CONFERENCE EVALAUTION SUMMARY How to Achieve High Reliability w...
WASHINGTON DC CONFERENCE EVALAUTION SUMMARY How to Achieve High Reliability w...
 
Daniel Jackson, UCB
Daniel Jackson, UCBDaniel Jackson, UCB
Daniel Jackson, UCB
 
Precepting a whole new world poster 2015 final
Precepting a whole new world  poster 2015 finalPrecepting a whole new world  poster 2015 final
Precepting a whole new world poster 2015 final
 
Carolyn Der Vartanian, (former) Clinical Excellence Commission
Carolyn Der Vartanian, (former) Clinical Excellence CommissionCarolyn Der Vartanian, (former) Clinical Excellence Commission
Carolyn Der Vartanian, (former) Clinical Excellence Commission
 
Understanding virtual fracture clinics
Understanding virtual fracture clinicsUnderstanding virtual fracture clinics
Understanding virtual fracture clinics
 

Ähnlich wie Scaling Innovation in Academic Medical Centers Through Collaboration

Revolutionizing HealthCare : a Comprehensive Analysis
Revolutionizing HealthCare : a Comprehensive AnalysisRevolutionizing HealthCare : a Comprehensive Analysis
Revolutionizing HealthCare : a Comprehensive Analysisdigitaltanisha2005
 
MCD Healthcare Leader Predictions featuring Mark Herzog and Dr. Steven Driggers
MCD Healthcare Leader Predictions featuring Mark Herzog and Dr. Steven DriggersMCD Healthcare Leader Predictions featuring Mark Herzog and Dr. Steven Driggers
MCD Healthcare Leader Predictions featuring Mark Herzog and Dr. Steven DriggersMark Herzog
 
mHealth Israel_Mony Weschler_Montefiore_How Data Exchange Is Essential In Sup...
mHealth Israel_Mony Weschler_Montefiore_How Data Exchange Is Essential In Sup...mHealth Israel_Mony Weschler_Montefiore_How Data Exchange Is Essential In Sup...
mHealth Israel_Mony Weschler_Montefiore_How Data Exchange Is Essential In Sup...Levi Shapiro
 
Webinar Replay: How To Provide High Quality, Low Cost Healthcare
Webinar Replay: How To Provide High Quality, Low Cost HealthcareWebinar Replay: How To Provide High Quality, Low Cost Healthcare
Webinar Replay: How To Provide High Quality, Low Cost HealthcareSocial Media Today
 
Will the next generation of doctors be ready for telehealth?
 Will the next generation of doctors be ready for telehealth? Will the next generation of doctors be ready for telehealth?
Will the next generation of doctors be ready for telehealth?VSee
 
Engage Front-line Care Team Using Clinical Audit Checklists
Engage Front-line Care Team Using Clinical Audit Checklists Engage Front-line Care Team Using Clinical Audit Checklists
Engage Front-line Care Team Using Clinical Audit Checklists iCareQuality.us
 
Session 4 - American Healthcare
Session 4 - American HealthcareSession 4 - American Healthcare
Session 4 - American HealthcareMedXellence
 
The mHealth + Telehealth World 2014
The mHealth + Telehealth World 2014The mHealth + Telehealth World 2014
The mHealth + Telehealth World 2014WorldCongress
 
Real-time Clinical Communication and Care Coordination
Real-time Clinical Communication and Care CoordinationReal-time Clinical Communication and Care Coordination
Real-time Clinical Communication and Care CoordinationiCareQuality.us
 
Telehealth: Vision, Barriers, Realization
Telehealth: Vision, Barriers, RealizationTelehealth: Vision, Barriers, Realization
Telehealth: Vision, Barriers, RealizationVSee
 
The post-COVID Value Shift & How MedTech Companies can Capitalize
The post-COVID Value Shift & How MedTech Companies can CapitalizeThe post-COVID Value Shift & How MedTech Companies can Capitalize
The post-COVID Value Shift & How MedTech Companies can CapitalizeGreenlight Guru
 
Strengthening Health Systems through the application of Wireless Technology
Strengthening Health Systems through the application of Wireless TechnologyStrengthening Health Systems through the application of Wireless Technology
Strengthening Health Systems through the application of Wireless TechnologyOPS Colombia
 
mHealth Summit EU 2015
mHealth Summit EU 2015 mHealth Summit EU 2015
mHealth Summit EU 2015 3GDR
 
Philips - Disruptive Change: How to save the healthcare system
Philips - Disruptive Change: How to save the healthcare systemPhilips - Disruptive Change: How to save the healthcare system
Philips - Disruptive Change: How to save the healthcare systemU.S. News Healthcare of Tomorrow
 
A CEO's Keys to Continuous Quality Improvement
A CEO's Keys to Continuous Quality ImprovementA CEO's Keys to Continuous Quality Improvement
A CEO's Keys to Continuous Quality ImprovementHealth Catalyst
 

Ähnlich wie Scaling Innovation in Academic Medical Centers Through Collaboration (20)

Revolutionizing HealthCare : a Comprehensive Analysis
Revolutionizing HealthCare : a Comprehensive AnalysisRevolutionizing HealthCare : a Comprehensive Analysis
Revolutionizing HealthCare : a Comprehensive Analysis
 
HL14028_brochure
HL14028_brochureHL14028_brochure
HL14028_brochure
 
Healthcare Magazine (issue - 38)
Healthcare Magazine (issue - 38)Healthcare Magazine (issue - 38)
Healthcare Magazine (issue - 38)
 
MCD Healthcare Leader Predictions featuring Mark Herzog and Dr. Steven Driggers
MCD Healthcare Leader Predictions featuring Mark Herzog and Dr. Steven DriggersMCD Healthcare Leader Predictions featuring Mark Herzog and Dr. Steven Driggers
MCD Healthcare Leader Predictions featuring Mark Herzog and Dr. Steven Driggers
 
mHealth Israel_Mony Weschler_Montefiore_How Data Exchange Is Essential In Sup...
mHealth Israel_Mony Weschler_Montefiore_How Data Exchange Is Essential In Sup...mHealth Israel_Mony Weschler_Montefiore_How Data Exchange Is Essential In Sup...
mHealth Israel_Mony Weschler_Montefiore_How Data Exchange Is Essential In Sup...
 
Webinar Replay: How To Provide High Quality, Low Cost Healthcare
Webinar Replay: How To Provide High Quality, Low Cost HealthcareWebinar Replay: How To Provide High Quality, Low Cost Healthcare
Webinar Replay: How To Provide High Quality, Low Cost Healthcare
 
Will the next generation of doctors be ready for telehealth?
 Will the next generation of doctors be ready for telehealth? Will the next generation of doctors be ready for telehealth?
Will the next generation of doctors be ready for telehealth?
 
Sandberg AAMC Innovations Report
Sandberg AAMC Innovations ReportSandberg AAMC Innovations Report
Sandberg AAMC Innovations Report
 
Engage Front-line Care Team Using Clinical Audit Checklists
Engage Front-line Care Team Using Clinical Audit Checklists Engage Front-line Care Team Using Clinical Audit Checklists
Engage Front-line Care Team Using Clinical Audit Checklists
 
Session 4 - American Healthcare
Session 4 - American HealthcareSession 4 - American Healthcare
Session 4 - American Healthcare
 
The mHealth + Telehealth World 2014
The mHealth + Telehealth World 2014The mHealth + Telehealth World 2014
The mHealth + Telehealth World 2014
 
Where Is Healthcare Going? And How Will We Get There?
Where Is Healthcare Going? And How Will We Get There? Where Is Healthcare Going? And How Will We Get There?
Where Is Healthcare Going? And How Will We Get There?
 
field-experiences.pptx
field-experiences.pptxfield-experiences.pptx
field-experiences.pptx
 
Real-time Clinical Communication and Care Coordination
Real-time Clinical Communication and Care CoordinationReal-time Clinical Communication and Care Coordination
Real-time Clinical Communication and Care Coordination
 
Telehealth: Vision, Barriers, Realization
Telehealth: Vision, Barriers, RealizationTelehealth: Vision, Barriers, Realization
Telehealth: Vision, Barriers, Realization
 
The post-COVID Value Shift & How MedTech Companies can Capitalize
The post-COVID Value Shift & How MedTech Companies can CapitalizeThe post-COVID Value Shift & How MedTech Companies can Capitalize
The post-COVID Value Shift & How MedTech Companies can Capitalize
 
Strengthening Health Systems through the application of Wireless Technology
Strengthening Health Systems through the application of Wireless TechnologyStrengthening Health Systems through the application of Wireless Technology
Strengthening Health Systems through the application of Wireless Technology
 
mHealth Summit EU 2015
mHealth Summit EU 2015 mHealth Summit EU 2015
mHealth Summit EU 2015
 
Philips - Disruptive Change: How to save the healthcare system
Philips - Disruptive Change: How to save the healthcare systemPhilips - Disruptive Change: How to save the healthcare system
Philips - Disruptive Change: How to save the healthcare system
 
A CEO's Keys to Continuous Quality Improvement
A CEO's Keys to Continuous Quality ImprovementA CEO's Keys to Continuous Quality Improvement
A CEO's Keys to Continuous Quality Improvement
 

Kürzlich hochgeladen

Chandigarh Escorts, 😋9988299661 😋50% off at Escort Service in Chandigarh
Chandigarh Escorts, 😋9988299661 😋50% off at Escort Service in ChandigarhChandigarh Escorts, 😋9988299661 😋50% off at Escort Service in Chandigarh
Chandigarh Escorts, 😋9988299661 😋50% off at Escort Service in ChandigarhSheetaleventcompany
 
VIP Call Girls Noida Sia 9711199171 High Class Call Girl Near Me
VIP Call Girls Noida Sia 9711199171 High Class Call Girl Near MeVIP Call Girls Noida Sia 9711199171 High Class Call Girl Near Me
VIP Call Girls Noida Sia 9711199171 High Class Call Girl Near Memriyagarg453
 
Call Girl Amritsar ❤️♀️@ 8725944379 Amritsar Call Girls Near Me ❤️♀️@ Sexy Ca...
Call Girl Amritsar ❤️♀️@ 8725944379 Amritsar Call Girls Near Me ❤️♀️@ Sexy Ca...Call Girl Amritsar ❤️♀️@ 8725944379 Amritsar Call Girls Near Me ❤️♀️@ Sexy Ca...
Call Girl Amritsar ❤️♀️@ 8725944379 Amritsar Call Girls Near Me ❤️♀️@ Sexy Ca...Sheetaleventcompany
 
Call Girl Raipur 📲 9999965857 ヅ10k NiGhT Call Girls In Raipur
Call Girl Raipur 📲 9999965857 ヅ10k NiGhT Call Girls In RaipurCall Girl Raipur 📲 9999965857 ヅ10k NiGhT Call Girls In Raipur
Call Girl Raipur 📲 9999965857 ヅ10k NiGhT Call Girls In Raipurgragmanisha42
 
Hubli Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Hubli Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetHubli Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Hubli Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetCall Girls Service
 
(Ajay) Call Girls in Dehradun- 8854095900 Escorts Service 50% Off with Cash O...
(Ajay) Call Girls in Dehradun- 8854095900 Escorts Service 50% Off with Cash O...(Ajay) Call Girls in Dehradun- 8854095900 Escorts Service 50% Off with Cash O...
(Ajay) Call Girls in Dehradun- 8854095900 Escorts Service 50% Off with Cash O...indiancallgirl4rent
 
VIP Call Girl DLF Phase 2 Gurgaon (Noida) Just Meet Me@ 9711199012
VIP Call Girl DLF Phase 2 Gurgaon (Noida) Just Meet Me@ 9711199012VIP Call Girl DLF Phase 2 Gurgaon (Noida) Just Meet Me@ 9711199012
VIP Call Girl DLF Phase 2 Gurgaon (Noida) Just Meet Me@ 9711199012adityaroy0215
 
VIP Call Girls Noida Jhanvi 9711199171 Best VIP Call Girls Near Me
VIP Call Girls Noida Jhanvi 9711199171 Best VIP Call Girls Near MeVIP Call Girls Noida Jhanvi 9711199171 Best VIP Call Girls Near Me
VIP Call Girls Noida Jhanvi 9711199171 Best VIP Call Girls Near Memriyagarg453
 
Call Girl Raipur 📲 9999965857 whatsapp live cam sex service available
Call Girl Raipur 📲 9999965857 whatsapp live cam sex service availableCall Girl Raipur 📲 9999965857 whatsapp live cam sex service available
Call Girl Raipur 📲 9999965857 whatsapp live cam sex service availablegragmanisha42
 
Russian Call Girls in Noida Pallavi 9711199171 High Class Call Girl Near Me
Russian Call Girls in Noida Pallavi 9711199171 High Class Call Girl Near MeRussian Call Girls in Noida Pallavi 9711199171 High Class Call Girl Near Me
Russian Call Girls in Noida Pallavi 9711199171 High Class Call Girl Near Memriyagarg453
 
dhanbad Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
dhanbad Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meetdhanbad Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
dhanbad Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetCall Girls Service
 
Sambalpur Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Sambalpur Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetSambalpur Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Sambalpur Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetCall Girls Service
 
❤️♀️@ Jaipur Call Girls ❤️♀️@ Meghna Jaipur Call Girls Number CRTHNR Call G...
❤️♀️@ Jaipur Call Girls ❤️♀️@ Meghna Jaipur Call Girls Number CRTHNR   Call G...❤️♀️@ Jaipur Call Girls ❤️♀️@ Meghna Jaipur Call Girls Number CRTHNR   Call G...
❤️♀️@ Jaipur Call Girls ❤️♀️@ Meghna Jaipur Call Girls Number CRTHNR Call G...Gfnyt.com
 
Krishnagiri call girls Tamil aunty 7877702510
Krishnagiri call girls Tamil aunty 7877702510Krishnagiri call girls Tamil aunty 7877702510
Krishnagiri call girls Tamil aunty 7877702510Vipesco
 
Call Girls Chandigarh 👙 7001035870 👙 Genuine WhatsApp Number for Real Meet
Call Girls Chandigarh 👙 7001035870 👙 Genuine WhatsApp Number for Real MeetCall Girls Chandigarh 👙 7001035870 👙 Genuine WhatsApp Number for Real Meet
Call Girls Chandigarh 👙 7001035870 👙 Genuine WhatsApp Number for Real Meetpriyashah722354
 
Jalna Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Jalna Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetJalna Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Jalna Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetCall Girls Service
 
VIP Call Girl Sector 32 Noida Just Book Me 9711199171
VIP Call Girl Sector 32 Noida Just Book Me 9711199171VIP Call Girl Sector 32 Noida Just Book Me 9711199171
VIP Call Girl Sector 32 Noida Just Book Me 9711199171Call Girls Service Gurgaon
 
Call Girls Patiala Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Patiala Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Patiala Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Patiala Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Service In Goa 💋 9316020077💋 Goa Call Girls By Russian Call Girl...
Call Girls Service In Goa  💋 9316020077💋 Goa Call Girls  By Russian Call Girl...Call Girls Service In Goa  💋 9316020077💋 Goa Call Girls  By Russian Call Girl...
Call Girls Service In Goa 💋 9316020077💋 Goa Call Girls By Russian Call Girl...russian goa call girl and escorts service
 

Kürzlich hochgeladen (20)

Chandigarh Escorts, 😋9988299661 😋50% off at Escort Service in Chandigarh
Chandigarh Escorts, 😋9988299661 😋50% off at Escort Service in ChandigarhChandigarh Escorts, 😋9988299661 😋50% off at Escort Service in Chandigarh
Chandigarh Escorts, 😋9988299661 😋50% off at Escort Service in Chandigarh
 
VIP Call Girls Noida Sia 9711199171 High Class Call Girl Near Me
VIP Call Girls Noida Sia 9711199171 High Class Call Girl Near MeVIP Call Girls Noida Sia 9711199171 High Class Call Girl Near Me
VIP Call Girls Noida Sia 9711199171 High Class Call Girl Near Me
 
Call Girl Amritsar ❤️♀️@ 8725944379 Amritsar Call Girls Near Me ❤️♀️@ Sexy Ca...
Call Girl Amritsar ❤️♀️@ 8725944379 Amritsar Call Girls Near Me ❤️♀️@ Sexy Ca...Call Girl Amritsar ❤️♀️@ 8725944379 Amritsar Call Girls Near Me ❤️♀️@ Sexy Ca...
Call Girl Amritsar ❤️♀️@ 8725944379 Amritsar Call Girls Near Me ❤️♀️@ Sexy Ca...
 
Call Girl Raipur 📲 9999965857 ヅ10k NiGhT Call Girls In Raipur
Call Girl Raipur 📲 9999965857 ヅ10k NiGhT Call Girls In RaipurCall Girl Raipur 📲 9999965857 ヅ10k NiGhT Call Girls In Raipur
Call Girl Raipur 📲 9999965857 ヅ10k NiGhT Call Girls In Raipur
 
Hubli Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Hubli Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetHubli Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Hubli Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
 
(Ajay) Call Girls in Dehradun- 8854095900 Escorts Service 50% Off with Cash O...
(Ajay) Call Girls in Dehradun- 8854095900 Escorts Service 50% Off with Cash O...(Ajay) Call Girls in Dehradun- 8854095900 Escorts Service 50% Off with Cash O...
(Ajay) Call Girls in Dehradun- 8854095900 Escorts Service 50% Off with Cash O...
 
VIP Call Girl DLF Phase 2 Gurgaon (Noida) Just Meet Me@ 9711199012
VIP Call Girl DLF Phase 2 Gurgaon (Noida) Just Meet Me@ 9711199012VIP Call Girl DLF Phase 2 Gurgaon (Noida) Just Meet Me@ 9711199012
VIP Call Girl DLF Phase 2 Gurgaon (Noida) Just Meet Me@ 9711199012
 
VIP Call Girls Noida Jhanvi 9711199171 Best VIP Call Girls Near Me
VIP Call Girls Noida Jhanvi 9711199171 Best VIP Call Girls Near MeVIP Call Girls Noida Jhanvi 9711199171 Best VIP Call Girls Near Me
VIP Call Girls Noida Jhanvi 9711199171 Best VIP Call Girls Near Me
 
Call Girl Raipur 📲 9999965857 whatsapp live cam sex service available
Call Girl Raipur 📲 9999965857 whatsapp live cam sex service availableCall Girl Raipur 📲 9999965857 whatsapp live cam sex service available
Call Girl Raipur 📲 9999965857 whatsapp live cam sex service available
 
Russian Call Girls in Noida Pallavi 9711199171 High Class Call Girl Near Me
Russian Call Girls in Noida Pallavi 9711199171 High Class Call Girl Near MeRussian Call Girls in Noida Pallavi 9711199171 High Class Call Girl Near Me
Russian Call Girls in Noida Pallavi 9711199171 High Class Call Girl Near Me
 
dhanbad Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
dhanbad Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meetdhanbad Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
dhanbad Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
 
Sambalpur Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Sambalpur Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetSambalpur Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Sambalpur Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
 
❤️♀️@ Jaipur Call Girls ❤️♀️@ Meghna Jaipur Call Girls Number CRTHNR Call G...
❤️♀️@ Jaipur Call Girls ❤️♀️@ Meghna Jaipur Call Girls Number CRTHNR   Call G...❤️♀️@ Jaipur Call Girls ❤️♀️@ Meghna Jaipur Call Girls Number CRTHNR   Call G...
❤️♀️@ Jaipur Call Girls ❤️♀️@ Meghna Jaipur Call Girls Number CRTHNR Call G...
 
Krishnagiri call girls Tamil aunty 7877702510
Krishnagiri call girls Tamil aunty 7877702510Krishnagiri call girls Tamil aunty 7877702510
Krishnagiri call girls Tamil aunty 7877702510
 
Call Girls Chandigarh 👙 7001035870 👙 Genuine WhatsApp Number for Real Meet
Call Girls Chandigarh 👙 7001035870 👙 Genuine WhatsApp Number for Real MeetCall Girls Chandigarh 👙 7001035870 👙 Genuine WhatsApp Number for Real Meet
Call Girls Chandigarh 👙 7001035870 👙 Genuine WhatsApp Number for Real Meet
 
Jalna Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Jalna Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetJalna Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Jalna Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
 
VIP Call Girl Sector 32 Noida Just Book Me 9711199171
VIP Call Girl Sector 32 Noida Just Book Me 9711199171VIP Call Girl Sector 32 Noida Just Book Me 9711199171
VIP Call Girl Sector 32 Noida Just Book Me 9711199171
 
9316020077📞Goa Call Girls Numbers, Call Girls Whatsapp Numbers Goa
9316020077📞Goa  Call Girls  Numbers, Call Girls  Whatsapp Numbers Goa9316020077📞Goa  Call Girls  Numbers, Call Girls  Whatsapp Numbers Goa
9316020077📞Goa Call Girls Numbers, Call Girls Whatsapp Numbers Goa
 
Call Girls Patiala Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Patiala Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Patiala Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Patiala Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Service In Goa 💋 9316020077💋 Goa Call Girls By Russian Call Girl...
Call Girls Service In Goa  💋 9316020077💋 Goa Call Girls  By Russian Call Girl...Call Girls Service In Goa  💋 9316020077💋 Goa Call Girls  By Russian Call Girl...
Call Girls Service In Goa 💋 9316020077💋 Goa Call Girls By Russian Call Girl...
 

Scaling Innovation in Academic Medical Centers Through Collaboration