Healthcare services can be frustratingly resistant to innovation. At the recent World Innovation Summit for Health (WISH) in Qatar, discussion was focused on how we can change practice within health services in order to improve healthcare. “Diffusion” was the buzzword. Rather than focusing on a specific innovation, the conversation among health leaders was about the process of getting more innovation into healthcare. According to Ara Darzi, entire fields like data science and artificial intelligence are “currently rich in opportunities, but poor in impact.” This is universally frustrating. Something must change if we are to deliver health care services that make use of the knowledge and opportunities that already exist, as well as the advances that will be coming down the pipeline.
Effy Vayena, professor of Bioethics at Harvard University, presented the challenge well: while there are regulatory and technical barriers to innovation, a key constraint are attitudinal barriers. In the context of data science, for instance, progress depends on not just interoperability, data security, and data curation, but on integration across sectors, data sharing agreements, and a regulatory framework that both fosters patient confidence and is flexible enough to facilitate rapid innovation.
So, how can we change practice within health services that might be set in their ways, even when they believe themselves to be innovative?
Part of the answer will be in overcoming the cognitive biases that slow the adoption of innovative practices. Maureen Bisognano from the Institute for Healthcare Improvement (IHI), said that one of the most effective ways to combat the “that sounds great but it wouldn’t work in our context” refrain is visiting somewhere in person to help open people’s minds to new possibilities and nudge them into innovating.
Another solution may be in putting design thinking at the heart of change. Don Berwick, president emeritus of the Institute for Healthcare Improvement, claimed that the first step is to let go of previous assumptions like “If we just try harder, we’ll have success.” Instead we should be more curious, accepting uncertainty, and emulating designers by paying attention to how people use and experience their surroundings. He advocated that all health leaders should have training in design thinking to achieve a genuinely human-centered health system. This means seeking input from patients and providers for every innovation. Real co-design (as opposed to simply getting these users to comment on a pre-formed plan) uses patient and staff expertise and passion, and has the potential to empower self-care.
By the end of the conference there was general agreement that adhering to the legacy of how things have always been done is the enemy of innovation in healthcare. And yet creating a shift towards innovation can be harder than it ought to be. Frustrated by slow progress, the long term thinking that is needed to power innovation may end up being driven by the bold vision of patients themselves. In fact, progress might hang on addressing the artificial binary of healthcare professional and healthcare recipient: everyone is a patient and carer at some point. As such, delivering innovation might actually hinge on bringing our own personal experience of healthcare to work. Harnessing the particular experience, passion, motivation, and vision of the people who use healthcare systems in a more personal way might just generate the boldness and daring needed to make the big changes.
Layla McCay, director of International Relations, NHS Confederation
Competing interests: Layla McCay attended the event at the expense of the WISH committee