Key barriers and facilitators


Key barriers and facilitators for innovation in healthcare

Six factors have been identified as the most important for healthcare innovations and they all need to be addressed and managed intelligently. If not, they are likely to create obstacles to the success of an innovation with regard to technological aspects, customer aspects, or the business model. For the North Sea Region, these factors are important considerations for obtaining a new, successful perspective on healthcare innovation. These are the six key barriers and facilitators:

  1. Players

As any great football coach will tell you, the players in the field make or break the team’s success. The second thing they’ll tell you is that you can only achieve greatness by striving for a joint goal, instead of personal gain.

“There is another side to ego that can wreck a team or an organisation. That is being distracted by your own importance. It can come from your insecurity in working with others. It can be the need to draw attention to yourself in the public arena. It can be a feeling that others are a threat to your own territory. Ego in these cases makes people insensitive to how they work with others and it ends up interfering with the real goal of any group efforts.”
Bill Walsh, American Football Coach

In the healthcare sector, there are many players on the field, each with their own agenda. Moreover, most innovation processes in the healthcare domain are currently initiated by entrepreneurs from outside of the sector. For the ecosystem to thrive, it’s important that innovation comes from both inside and outside of the sector.

Innovation must either match the agendas of the different players, or demand that the players adjust to the innovation in order to thrive. This means that a successful innovation ecosystem takes into account the commercial parties, the healthcare professionals and the end users in a stakeholder analysis. Such an analysis should focus on their interests and agendas in healthcare innovation.

  1. Funding

In most other sectors, one rule stands above all others when it comes to innovation: revenues must be generated and capital must be acquired. In the healthcare setting however, it is not often easy to distinguish which parties will be responsible for these streams of income. Will the patients or the healthcare professionals be the end consumers? Both parties could complicate the development process, as well as the implementation of healthcare innovation.

Another factor is that the first economic benefits of healthcare innovation don’t necessarily end up with the initial investors, so who will provide the initial funding? For this reason, it’s vital that the financial options are weighted, especially when considering scale-ups.

A financial construct that addresses these problems is the Social Impact Bond, sometimes also referred to as Health Impact Bond. A social impact bond brings together government, service providers and investors/funders to implement existing and proven programmes designed to accomplish clearly defined outcomes. Investors/funders provide the initial capital support and the government agrees to make payments to the programme only when outcomes are achieved.

social impact bounds
  1. Policy

The third factor is policy, described as ‘the regulations that pervade the industry, because incompetent or fraudulent suppliers can do irreversible human damage.’ The main problem with policy is that healthcare is regulated by law, which is sturdy and hard to change. Therefore, the hands of many stakeholders in the innovation model can be tied, and regulations may prevent the innovation from developing to the next level.

In healthcare especially, it is essential to examine where the innovative product or service fits in the current healthcare system, including the fit with current (patient) safety procedures because changes in healthcare policy are slow and unpredictable, which can kill the innovation.

  1. Technology

Technology can be a driver for innovation in fields such as treatment improvement and healthcare delivery. However, successful technological healthcare innovation requires perfect timing. Too soon and the healthcare professionals might not be persuaded because the evidence is lacking, too slow and there is the risk of other innovations catching up with the idea. This tug-of-war should be discussed at an early stage, along with the presumed competition.

Secondly, different phases of development require different funding. Most of the time, the initial funding is acquired from grants or governments. However, when the idea or product enters the testing and implementation phase, it is difficult to obtain secondary funding. That is why this phase is often referred to as ‘the valley of death’. It is key to start looking for investors for phase two while still solidly operating in phase one.

  1. Consumers

Because of the full access provided by the internet, healthcare customers are rapidly becoming more empowered, reading more healthcare literature and relying less and less on doctors and other professionals. This may make the market for healthcare innovation less predictable. However, it may also provide opportunities. For instance, customers can be involved in the development process or show their support via crowdfunding. It also opens up marketing opportunities by reaching out directly to the end consumers.

  1. Accountability

Today, stakeholders demand measures of effectiveness, such as health technology assessments or other effectiveness evaluations to prove an innovation is worth investing in. Moreover, particularly in healthcare, patient safety should be guaranteed.

However, such requests are in direct conflict with the process of cyclic innovation, including customer engagement in the development process, testing, start-up and scale-up of the innovation. In other words, accountability is a grey area with regard to innovations. It’s important to keep in mind that accountability is also highly subjective and influenced by perceptions. Once it has been suggested that an innovation is unsafe, unproven or not evaluated properly, policymakers, customers and healthcare regulators may be sceptical about the innovation, which causes the chance of success to diminish rapidly.