Cases Health-Technological Innovation and EU
Competencies
Case 1, Health and technological innovation
Technology and its definitions
Barlow (2017):
The consensus is that technology is concerned with the application of knowledge to solve
problems.
A distinction is usually made between hard technology, tangible artefacts such as computers
or mobile phones, and soft technology, the knowledge about how those artefacts work.
Mitcham (1994) argues that technology has four dimensions: knowledge, activity, objects,
and volition.
Schon (1967) described technology as ‘Any tool or technique: any product or process, any
physical equipment or method of doing or making by which human capability is extended.’
Oslo Manual: The whole complex of knowledge, skills, routines, competence, equipment,
and engineering practice are closely associated with ‘innovation’.
Technology forms part of a ‘socio-technical system’; a system where people, organizations,
institutions, and technologies interact and its role is subject to processes of ‘social
construction’, where understandings of the world and shared assumptions about reality are
jointly constructed by individuals.
There is a jointly construct technology to meet their goals and needs.
Critique:
Definitions are broad and it’s hard to distinguish the knowledge.
Technology is a social construct
Implementation of technologies can be challenging and unpredictable.
We affect the way technology is used and evolves, and thus the factors that enable or inhibit
technological innovation.
Innovation / Health Technological Innovation (HTI)
Innovation is both an outcome and a process. It involves the act of turning an idea or
invention into something that can be sold to customers or somehow made practical use of.
‘Innovation’ in healthcare has become associated with new developments in the field that
allow for improvements in solving problems, in this instance, healthcare problems.
The World Health Organization (WHO) explains that ‘health innovation’ improves the
efficiency, effectiveness, quality, sustainability, safety, and/or affordability of healthcare.
,This definition includes ‘new or improved’ health policies, practices, systems, products and
technologies, services, and delivery methods that result in improved healthcare.
Department of Trade and Industry, UK, definition of innovation (DTI, 2004):
o The action or process of innovating.
o A new method, idea, product.
o The successful exploitation of new ideas.
Lewis Duncan, described innovation as ‘the ability to convert ideas into invoices.’
Innovation is also sometimes associated with individuals who have characteristics: inventors,
entrepreneurs, risk takers.
Rogers (2003):
An idea, practice or object that is perceived as new by an individual or other unit of
adaption.
Schon (1967):
The process of bringing inventions into use. It can refer to the outcome (physical objects,
new services, business models) or processes by which these are developed.
Christensen et al. (2004):
Anything that creates new resources, processes or values, or improves a company’s existing
resources, processes or values’.
Drucker (1985):
The effort to create purposeful, focused change in an enterprise’s economic or social
potential.
Rae-Dupree (2008):
A slow process of accretion, building small insight upon interesting fact upon tried-and-true
process.
Fonseca (2002):
A new patterning of our experiences of being together, as new meaning emerges from
ordinary, everyday work conversations … a challenging, exciting process of participating with
others in the evolution of work.
~Conclusion~
Innovation is not necessarily a product → it’s more about the systems innovation and the
application of new ideas.
Solution vs. innovation
An innovation is a new, better, and effective way of solving problems.
In order for a solution to a healthcare problem to be an innovation, it must introduce
something that is new or significantly different from other solutions in the field.
,Innovation = Invention + exploitation
An innovation has both:
o a creative dimension (often described as ‘invention’)
o a commercial or practical dimension that involves the exploitation of the invention
(can it be realistically implemented?).
Innovations can be classified in different ways:
according to their scope (their degree of novelty)
their form (whether they are product, process, service innovation)
their ‘innovativeness’ (how much innovation there is in their components and from
whose perspective?)
These allow us to distinguish between incremental and radical — or continuous and
discontinuous — innovations, along with various other subcategories.
Key points of an ‘innovation’:
o New ideas
o Exploitation, idea must be implementable and value generating
o Successful, adopted by a target audience
An innovation has:
o A novelty
o An application component
o An intended benefit
Demand for the innovation:
is it pushed by the developers of a new technology or service, where there was
previously no demand, such as the e-book
it is pulled by expressed demand, perhaps the need to reduce production costs or
address a safety or quality issue
Different types of (technological) innovation and technology
Incremental innovation
Refers to the ability to develop products that are new to the firm.
Radical innovation
Represents the ability to develop products that are completely new to the world or
particular industry.
Disruptive innovation
Breaks traditional ones and provides new products and technologies that are more
accessible.
, Social innovation – new approaches to tackle social issues and solve problem
Health innovation – new mechanisms to improve population health
Product innovation – new goods and services within the market
Process innovation – enhancement of the production of goods and services
Hard technology
The physical artefacts: drugs, devices, other equipment, and physical infrastructure.
Soft technology
The practices, procedures, protocols, service designs and guidelines that are often used in
conjunction with hard technologies: a protocol for carrying out an innovative surgical
technique, for example, or more broadly a service design for providing ‘telehealth’ or
‘telecare’ for frail elderly people, combining sensors and other devices to monitor vital and
other signs with home care services.
How technological innovations shape public health
Technology supports the way in which professionals can gather and analyze information and
provide improved care to communities.
PH professionals have opportunities to create and use dynamic PH technology solutions that
can have a profound impact on patient care.
Most healthcare innovations involve some combination of ‘soft’ and ‘hard’ elements and the
interplay between them means that many healthcare innovations are both ‘process’ and
‘service’ innovations.
Examples of current and recent innovations
Fitness bands
Reference point when communicating with healthcare professionals.
Monitor for vital statistics
Such as heart rate, lung function, blood oxygen level, and blood sugar.
Hard technological innovations:
1. Robotic heart catheter
2. Diagnosing cataracts by smartphone
Soft technology innovations:
1. Bupa care services improving residential care by digitalizing quality processes
2. University hospitals Southampton finding the missing millions and reducing
admissions through medical intelligence
,Digitalization in health care
Digitalization is used as a tool in the healthcare system.
It is a mean not an end, and it shouldn’t be the aim, it's just a way to reach the main goal.
Digitalization should not modify public health principles; rather it should support and enable
their implementation.
Advantages:
- Supports the transition from cure to prevention
- Helps to put people and patients at the center of care delivery
- Supports patient empowerment
- Makes the healthcare system more efficient: less administrative work, so less time
consuming
- Fast access to data
- Safer
- More affordable
Digital solutions:
Benefits are enabled through the following features of digital technologies:
Automation
Prediction
Data analytics
Personalization and precision
Interaction
- Automation prescription medicine
vending machine/drug dispenser
- Prediction (early detection)
prediction model for vaccines by WHO
- Data analysis statistical data
gathering and sharing to predict risk
groups
- Personalization and precision
personalized training for health care
professionals & genome based
personalized approaches for patients
- Interaction health related
smartphone apps for the general
population to generate their own
health
Prevention
, Primary prevention:
Make prediction models, risk factors and applications to prevent.
Example. Apps & sensors = step tracking devices prediction factor for certain diseases
Secondary prevention:
Genetic basis to prevent development of disease, based on actual genetic facts.
Example. Genetic data base to see someone’s risk/chance for certain diseases
Pros, cons, and barriers of health technological innovation
Pros of HTI
1. It supports the transition from cure to prevention
2. It helps to put people and patients at the center and supports their empowerment
3. It makes healthcare management and delivery more efficient, safer, and cheaper
4. Technology is useful in achieving our goals, takes over routine monotonous tasks, makes
our lives comfortable, makes complex tasks easier and creates values for users and
society, easier monitoring, better access, surgical advances, new drugs
Cons of HTI
Risks of harm to the patients (precautionary principle), thus need of research
Privacy
Costs (HTI can be very expensive)
Environmental pollution
Can create stress when not used properly
Change may produce little to no improvement or benefit and may unexpectedly cause
negative results or outcomes.
Barriers
Collaboration, communication, and knowledge exchange between those involved within
the system is needed
Newly introduced ideas, methods, products and/or the process of introducing something
new in healthcare face the burden of being accepted within the field.
Stakeholders and their interests
Funding and costs
Policy and government regulations
Competition and other developments
Consumer views and opinions (not everyone will be happy or will agree with HTI)
Accountability
Factors that influence health technological innovation in public health
