HPI4002: Innovation and Quality Management of Health Services (HPI4002)
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Summary HPI4002 Innovation and Quality management of Health Services
Case 1: We need to innovate!
Learning goals:
1. What is an innovation?
While innovation – thinking creative about what healthcare is and how we deliver it – is
needed more than ever, innovation can itself be a problem. New technologies often
increase costs because they allow us to ‘do more’ healthcare.
The term ‘innovation’ is overloaded with meaning. It can refer to an outcome – we often
implicitly use it in relation to physical objects or products – and it can refer to the processes
by which these are developed.
- Innovation has both a creative dimension (often described as ‘invention’) and a
commercial or practical dimension that involves the exploitation of the invention.
Only when both these dimensions are effectively managed does one have an
innovation.
Box 2.4 Summary: Defining innovation – the key points
- New ideas – a new (or improved) product, process or service, or a whole new
business or business model
- Exploitation – the idea must be implementable and potentially value generating (i.e.
innovation = invention + exploitation)
- Successful – the innovation is adopted by the target audience
- ‘New’ is a relative term – it can mean ‘new to the world’, ‘new to the market’ or
‘new to the firm’. also ‘new to the individual adopter’
Innovations have been categorised in various ways.
- One distinction is according to where the demand for the innovation is originating –
is it pushed by the developers of a new technology or service, where there was
previously no demand, or is it pulled by some kind of expressed demand, perhaps
the need to reduce production costs or address a safety or quality issue. Innovation
tends to be an interaction between the two.
- Another distinction that is often made is between ‘incremental’ and ‘radical’
innovation. For much of the time innovation is about exploiting and elaborating
ideas, creating variations on a theme within an established technical or market
trajectory. Occasionally, however, breakthroughs occur, creating a new technology
trajectory at which point the cycle repeats itself.
It is sufficient to classify innovations in three ways, according to:
- Their scope, i.e., their degree of novelty (how new they are),
Medical innovation has been defined as a significant departure from previous
techniques in a field, as determined by the collective judgments of experts.
Another definition of newness relates to ‘recency’, either the actual or perceived
time that something has been in the world.
,Box 2.5 Concepts: The ambiguity of ‘newness’ and ‘differentness’
Classification of innovations according to the degree to which they are new to a
market or new to a company operating in the market.
Categorisation of innovations according to the novelty of innovation outcomes and
the extent to which innovation activities mean an organisation or company has to
acquire new capabilities – expertise, equipment or knowledge.
- Their form or application (whether they are product, process, service) and,
Three principal forms of innovation are:
, o Products – tangible physical objects that are acquired and then used by
consumers
o Services – intangible things, where the consumer benefits from the service,
but does not actually acquire an object
o Processes – the equipment, methods, systems used by producers of products
or services
- Their innovativeness (how much change there is in their components, compared to
the current norm) (modular?)
The process of innovation has commonly been divided into three stages, known as ‘the
Schumpeterian trilogy’:
- The invention phase: where ideas are turned into workable inventions, is typically
characterised by experimentation to prove the concept.
- The technological potential of an invention has to be transformed into economic
value. Commercialisation is where the latent value of a technology is unlocked in
order to generate real value.
- Adoption and diffusion are the process by which innovations are taken-up and
spread through a population.
Successful innovation requires the entire process from invention to diffusion.
- It is seen as too linear; the actual process is more complex.
How an innovation is introduced and the path it subsequently takes is strongly influenced by
the prevailing structural characteristics of the given health system, in the form of:
- cultural features (such as norms of practice, agreed standards of evidence,
professional identities, and codes of conduct,
- physical features (such as the infrastructure of hospitals and other facilities or the
existing technological architecture), and
- institutional features (the configuration of organisations, regulations, and financial
systems that comprise health systems).
a. Different types of innovations
There is much interest ‘disruptive innovation’, moving towards cheaper, simpler
organisational, and technological solutions which emphasize the importance of individuals
taking more responsibility for their own care and shifting services away from expensive
hospitals to community settings.
Broadening what we mean by innovation to embrace the whole process from initial idea to
implementation and diffusion is essential.
- Technological innovation, to create affordable new drugs, devices, diagnostics, and
vaccines that are more cost-effective than existing interventions; and
- Social innovation, to ensure the distribution of essential goods and services,
including new technologies
Types of innovation – radical, incremental and others
, Continuous innovation improves but preserves the current way of doing things.
Discontinuous innovation leads to some kind of disruption to the status quo. They may even
require a very different set of capabilities and new behaviour patterns.
Radical innovation and discontinuous innovation are used synonymously.
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