Healthcare Innovation

The following sections are included:

• About the Editors
• Contents
• Introduction

The COVID-19 pandemic is arguably the greatest healthcare crisis in the post-war era, causing huge disruption to global medical systems in addition to high rates of mortality and morbidity. But while it has caused dramatic upheaval worldwide, it has also led to a period of significant and positive innovation. This in turn has resulted in major advances in how healthcare is perceived and delivered. In the UK, we have seen fast-tracked digital adoption, centralised government support, and an urgency to find solutions in an entirely new social context. The subsequent paradigm shift in healthcare approach will have fundamental consequences for the industry.

In this chapter, we investigate how innovation driven by the pandemic is challenging conventional approaches to healthcare delivery and accelerating the development and adoption of new digital technologies and care models. We find that the blurring between medical industries, technologies and services has the potential to democratise healthcare provision, improving outcomes and experiences. But this future is far from certain and will depend on the attitudes of governments, regulators, and society towards a new digital healthcare paradigm.

This work aims to assess how innovation is managed by state-owned hospitals in Portugal. From an initial literature review, two research questions arise, the first addressing the current status quo on the management of innovation activities, and the second questioning if an innovation management system can bring value to the existing processes.

Based on the analysis of 10 interviews recorded in two institutions, how organisations manage innovation has been analysed.

The main conclusions point to the fact that hospitals seek to develop a manageable innovation strategy, creating incentives and structures to support innovation activities by their workers and parties involved in the innovation ecosystem. However, they still have difficulty in maintaining a steady and continuous innovation activity, and also have significant difficulties in monitoring and evaluating the impact of innovation activities, and associated results, on the organisation. Despite the existence of several indicators to monitor the innovation processes, due to the lack of resources, it is the ex-ante and the ex-post assessment of the innovation projects are often disregarded.

Considering the existing situation, and based on the evidence found, the implementation of an innovation management system could contribute to improve the performance of the organisation with regards to innovation. For that purpose, this work suggests the implementation of specific mechanisms to manage and monitor the innovation activities.

As for future research activities, they could extend the scope of the study to private and public hospitals to compare best practices and use a mixed-method approach to improve the scientific outcomes.

This chapter provides an illustration of how the support for innovation work has been developed at Karolinska University Hospital. Karolinska is a large university hospital in Sweden that provides highly specialised healthcare together with research and education. The chapter presents a ‘journey’ spanning the period 2011–2020 whose overall goal was to support innovation efforts at the hospital. During that time, different initiatives to achieve the goal were launched. These included establishing expertise in forming and leading innovation partnerships; developing a portfolio of educational programmes for clinical staff regarding innovation management; utilising the opportunity to certify the hospital’s innovation management professionals; engaging in the development of ISO standards for innovation management; and designing and implementing a hospital-wide innovation management system. This journey is then reflected upon, and the specific issues of adapting innovation management to a healthcare context and developing innovation management support in a hospital setting are discussed. This all serves as input for how to address innovation management as well as for future models of healthcare delivery.

Hackathons are events that are based on the concept of open innovation, where organisations open up their innovation processes to internal and external participants to develop new ideas and solutions. Due to the wide range of applicability, hackathons have been used across industries to foster innovation and problem solving. However, several factors have to be considered regarding the organisation of these events, which need further improvements for better outcomes. At this point, the Vienna Innovation Model (VIENNO), which makes organisations aware of the inclusion of the ecosystem and its holistic view, can be used as a framework to organise efficient and innovative hackathons with greater success. VIENNO allows large, established healthcare organisations to imagine the future of healthcare. By eliminating some of the perceived risks, hackathons can be an effective way for large organisations to deliver breakthrough innovations at start-up speed. VIENNO hacks the old processes focusing on a concrete output in its cross-functional structure by fostering a patient-centric and can-do culture.

The COVID-19 pandemic brought challenges to society, demanding local and innovative solutions due to the lack of international suppliers. In Brazil, led by the University of Sao Paulo, an emergency pulmonary mechanical ventilation equipment, cheaper than the existing equipment, was developed in a month to be manufactured by local industries, involving 40 multidisciplinary researchers and companies from different sectors. The ability to create this solution articulated by several actors in a small amount of time and with limited resources led us to study this case as an opportunity to learn and be well prepared to face other turbulent contexts. We found that a multidisciplinary knowledge-intense network provided the ground where orchestrators emerged. These orchestrators assumed roles that were not part of their job but were part of their skills. They worked together, taking the roles related to their network and skills. With their legitimacy within the organisation and within society, these orchestrators, leveraged by the communication of a clear mission, fostered access to knowledge and other resources. This chapter briefly describes the case and provides some reflections about the roles augmented for turbulent times, the embedded network, and the orchestrators’ skills throughout the innovation journey.

The COVID-19 pandemic has highlighted new and existing challenges for the delivery of healthcare staff training, medical students learning programmes, and meeting both COVID-19 and non-COVID-19 patient requirements. Healthcare systems globally have and continue to experience these challenges, including a severe backlog of clinical activity. Torbay hospital (NHS-UK) has previously existing knowledge in the technology sphere that has been applied to identify and resolve pandemic priorities and needs. Access to Technology-Enhanced Learning (TEL) tools and services has enabled Torbay in expanding and scaling up technologies to deliver solutions. Using the ‘double-diamond’ design thinking methodology process, multi-expert teams (clinicians, educators and TEL developers) worked together to address some of the pandemic challenges. As a result of the rapid innovation that Torbay has undertaken, several use cases have emerged which may be applicable to healthcare workers, medical students and patients, nationally and internationally. In this chapter, we describe factors that enabled innovation, our thoughts on sustainability of the interventions post-pandemic and limitations of the tools. The primary aim of our chapter is to encourage healthcare providers to establish discourse on the role of TEL innovation for meeting COVID-19 priorities and to help inform further opportunities for innovation in the NHS. Our intention is to encourage other healthcare providers to explore design thinking and generate their individual TEL use cases.

Health organisations around the world are constantly seeking tools and methods to manage patients’ pain more effectively. This has been in the forefront of pain research for decades. Methods such as hypnosis, meditation and relaxation techniques alongside technological tools such as the use of video, audio and gaming are applied and investigated. With the advancement of technology, new tools such as Virtual Reality (VR) are used more and proved to be effective. However, the effectiveness of VR seems to be highly dependent on context, patients, measurements and applications. This chapter looks into the application of VR in Acute Pain management, common areas where it is used in and how it is evaluated. The chapter concludes by providing recommendations for enhancing the use of VR in the management of acute pain and offering insights into what to expect in the future.

ALAMEDA is an international and multidisciplinary research project funded by the EU in the frame of the H2020 Research and Innovation Framework Programme aiming to bridge the early diagnosis and treatment gap of brain diseases via smart, connected, proactive and evidence-based technological interventions. The present chapter illustrates the overall integrated, multidisciplinary and participatory approach to brain healthcare that ALAMEDA promotes by developing and testing the next generation AI-based healthcare support systems. Innovative technologies and models are meant to provide personalised disease monitoring as well as rehabilitation and treatment assessment for patients with Parkinson’s disease, multiple sclerosis and stroke (PMSS). This will support the design of outcome-driven interventions, allow that situations likely to aggravate can be predicted and boost the transition to value-based healthcare models.

As the project is still ongoing, the chapter specifically focuses on a thorough overview of the respective care journeys, focusing specific attention on current healthcare service organisation and provision, their degree of multidisciplinarity and integration as well as digitalisation and personalisation. In addition, the authors dive into the three national contexts where the ALAMEDA solutions are being tested and discuss current workloads and procedures, the interconnectedness of services and providers at the local level and the efforts currently being made to give increasing weight to patients’ preferences in medical decision-making. From the insights obtained via desk search and direct consultation with the involved clinicians, the document points out the enabling and potentially hindering factors for the future development and deployment of the solutions locally. Last, the chapter describes the end users’ adopted engagement strategy and how the concepts and models from other research projects (such as MULTI-ACT) and well-established practices in medical settings (i.e. shared decision-making) are interpreted and adapted into the context of the innovative value-based healthcare digital transformation framework promoted by the ALAMEDA consortium.

This chapter explores the emergence of Redistributed Manufacturing (RDM) as a disruptive system that can help address wicked or complex problems in healthcare, which cannot easily be solved by individual disciplines alone. RDM is presented as a new field of practice, whereby a transdisciplinary innovation lens is pivotal for understanding the complexity of the phenomenon and pathways to adoption. This chapter provides the theoretical basis for four critical research propositions to guide future research that robustly considers healthcare system readiness and the evidence base for where to best deploy RDM.

The following section is included:

• Index