What do we know about innovation in healthcare?
We know that there is a gap between growing care needs and shrinking available resources to meet them – and that innovation has to be part of the solution to bridging this gap.
We know that innovation is especially hard because healthcare is such a complex and often highly politicised system.
We know about the barriers to commercialising new health technology products such as the so-called ‘valley of death’ between the R&D stages and before commercial finance starts to flow.
And we know all about the barriers to technology adoption and diffusion – the challenges associated with organisational, funding and leadership factors, and the part played by the evidence base for healthcare innovations.But I believe there are four big issues that we need to start thinking about more seriously when discussing innovation in healthcare, especially in developed countries.
|Controlling the system |
Francis Spufford’s novel Red Plenty follows a cast of characters – economists, computer programmers, biologists, writers, fixers – around the Soviet Union of the 1950s and 1960s. This was time of optimism, when the planned economy would become, in Spufford’s phrase, ‘its own self-victualling tablecloth.’ One of those characters was Vasily Nemchinov, architect of the scheme to reform the Soviet economy mathematically. ‘Cybernetic’ institutes were established, mathematical and linear programming models were developed for balancing supply and demand over the short- and long- terms, for different economic sectors and on local, regional and national scales.Read more
|Asking ‘why not?’ rather than ‘why?’ |
Technological innovation is a double-edged sword. It has brought huge benefits for all of us by reducing suffering and extending life. But it has allowed healthcare to do more – in all developed countries people are increasIngly ‘overdosed, overtreated, and overdiagnosed’, as Moynihan and colleagues put it in a 2012 BMJ paper.
This is nothing new. In 1976 Ivan Illich wrote in Limits to Medicine that the medical establishment has become a major threat to health. A BMJ theme issue, Too Much Medicine, in 2002 cited Amartya Sen’s observation that the more we spend on healthcare, the more the population is likely to regard itself as sick.
So what can be done – and where does innovation fit in? Read more