In our EHFF Newsletter, posted October 23rd, I promised a review of EHFF’s changing view of the future over the 15 years or so that EHFF has identified as a futures organisation. Here’s the second of the levers for change in the process of healthcare transformation that we had identified.
Innovation: EHFF came to this subject with substantial knowledge of theories and examples of transformational change in organisations stemming from the interests of its previous incarnation, ESQH (e.g. the work of Ralph Stacey in the UK and of Shoji Shiba from MIT and the University of Tsukuba). Leading a work package on innovation in the EC project PROSTEP (Promoting Self-management for chronic diseases in Europe: 2016-2018: see https://www.eu-patient.eu/globalassets/projects/prostep/pro-step-final-report.pdf ) which tasked us to devise a taxonomy for innovation in health, helped us to appreciate the profound work on adoption of innovation of Trish Greenhalgh and her collaborators at Oxford, which set down a very well researched and persuasive framework for understanding success and failure of adoption in health and social care (Greenhalgh et al: http://www.jmir.org/2017/11/e367/ Beyond Adoption: a new Framework), which we recommend as a primary reference on the subject.
Prior to this, Clayton Christensen and his colleagues had been promoting the idea of disruptive innovation and their book, ‘The Innovator’s Prescription: A Disruptive Solution for Health Care’ (2008) led to attempts by some European healthcare systems to put these ideas into practice (many of such attempts seeming to misunderstand or seek to dumb down the original ideas). EHFF therefore took a keen interest in the subsequent consultation report from the European Commission EXPH (Expert panel on effective ways of investing in health) on Disruptive Innovation: https://ec.europa.eu/futurium/en/system/files/ged/54_-_disruptive_innovation_ec_-_expert_panel_health_2015.pdf
EHFF was among many organisations and individuals who responded to the consultation. Although we don’t agree with all the conclusions of the report, it still remains for us a ‘go-to’ source of expert opinion (and, incidentally, it offers opinions on much wider issues than disruptive innovation, including health promotion and the future shape of healthcare professionals education).
Understanding barriers to adoption particularly in complex systems and equally the potential value of disruptive innovation principles applied to health and social care represent for us key lessons for transformation from the last decade.
Future of innovation?
Two thoughts: firstly, the commercially driven nature of product development and marketing (see the next instalment for more on this) means that too often ‘innovative’ products/procedures are simply re-packaged versions of what already exists. After all, the acid test for us, based on previous work, is that innovation actually means in practice doing something differently than before, with better results, not simply achieving the same thing but more efficiently. Nevertheless, there are indeed clearcut examples of genuine innovation to be seen, such as the amazing speed with which vaccines can now be produced, using genetic engineering.
Secondly, at EHFF we have looked more closely at systematic reasons for innovation failing to embed within organisations. Our Anglo-Dutch lead for the transformational catalyst working group, Daniel Steenstra, has very recently published two blogs on the subject. The first ‘why your next innovation will die’ https://danieliao.substack.com/p/why-your-next-innovation-will-die, discusses governance problems at the heart of failure of adoption and the second offers one novel solution that could work to overcome this fundamental barrier https://danieliao.substack.com/p/genetic-engineering-of-governance .
Work in progress!