The phrase ‘health innovation’ brings to mind silicon valley tinkerers and billion dollar big pharma companies. But the best ideas aren't necessarily found within big companies, top universities or established networks.
Health policymakers and leaders are starting to realise this. Our new report, Open Innovation in Health, explores how governments, researchers, companies, practitioners, patients and citizens around the world are collaborating in new ways to open up health innovation.
It analyses an emerging set of methods which involve a wider range of people, with several overlapping goals. Some seek to make health innovation more efficient, or to inform it with a better understanding of population and health system needs. Others seek to make health innovation more democratic, by giving citizens a greater say in setting priorities. And some seek to do all three of these things.
Open Innovation approaches are being applied across the health innovation cycle, to improve problem identification, invention, and the adoption and diffusion of innovations.
At the stage of problem identification, open innovation can mean involving a wider range of actors in collecting and sharing data to more efficiently monitor health issues, for example through data mining and data crowdsourcing. It can also mean giving citizens a role in informing the health innovation agenda, through participatory priority setting and peer research.
A good example is the the Community Health Agent Programme in Brazil. The programme employs community health agents (CHAs) - established residents of a given neighbourhood, with the ability to build effective relationships with other local residents - to provide insights into the problems experienced by the communities they work in. These insights are used to inform wider public health activities. In São Paulo, intelligence gathered by CHAs has been used to inform health workshops for groups who have been identified as at particular risk. Evidence suggests that the model leads to better access to and satisfaction with services, and it has been associated with substantial improvements in both child and adult health.
Inventors are often imagined as lonely geniuses working away in a lab. By contrast, open innovation involves bringing a wide variety of actors together to generate new ideas and possibilities. Open innovation at this stage can take the form of collaborating to tackle neglected health issues, for example through challenge prizes and data-sharing initiatives. It can also mean bringing innovators close to health systems and patient needs, for example through pre-commercial procurement programmes, clinician innovation programmes, and ethnographic and design approaches. It can equally mean opening up the invention process to citizens, so that innovation processes better reflect their priorities, using methods such as co-production and co-design.
The Open Medicine Project South Africa (TOMPSA), for example, is a collaboration of healthcare workers, researchers, mobile technology designers and developers, who are tackling health system problems - especially in the developing world - by creating smartphone applications. TOMPSA draws on the insights of primary health workers through participatory design sessions, alongside technology designers - and with academic input - to map out information needs. Since launching, the project has produced simple, practical mobile applications covering HIV, tuberculosis, emergency and primary healthcare, which have been used by more than 300,000 health practitioners in over 198 countries around the world.
Innovation has sometimes been described as invention plus adoption. There is ample evidence that good ideas do not ‘sell themselves’: the processes by which new ideas are tested, adapted and ultimately adopted are vital. Collaborative approaches to promote successful and timely adoption of new ideas include publicising promising innovations, for example through online marketplaces and diffusion support programmes.
An interesting collaborative attempt to drive diffusion is the NHS Innovation Accelerator, is a fellowship programme which supports selected participants - a mix of clinicians, SMEs and academics - to scale up their innovations within the NHS. In its first 17 months, the accelerator supported 17 fellows to get their interventions taken up in 419 organisations, and to raise over £20 million in funding. One successful innovation accepted in the first year of the NIA was the PneuX Pneumonia Prevention System, a cuffed ventilation tube which aims to prevent ventilator-associated pneumonia (VAP), the most common cause of hospital-acquired mortality in Intensive Care Units in England. Since the joining the NIA, PneuX has had a successful hospital trial, including an economic evaluation which showed a saving of £718 for each patient receiving treatment with the PneuX.
The new possibilities offered by these more ‘open’ forms of innovation also come with new challenges and tensions. These range from the complexities of patient- or citizen-generated data to the challenges of opening priority setting up to greater participation while avoiding capture by narrow (but influential) sectional interests. The challenge facing aspiring ‘open innovators’, we suggest in our report, is not to perfectly resolve these tensions, but to negotiate them.
To find out more about emerging approaches to Open Innovation in health from around the world, download the full report here.
Image credit: Mohammed Dalwai