Summary course BMZ2026
Implementi ng innovati ons in healthcare
Case 1
Different definitions of innovation:
- ‘An innovation is an idea, practice, or object that is perceived as new by an individual or
other unit of adoption. It matters little, so far as human behavior is concerned, whether or
not an idea is objectively new as measured by the lapse of time since its first use of
discovery.’ (Rogers)
- ‘Innovation is the implementation of an internally generated or borrowed idea – whether
pertaining to a product, device, system, process, policy, program or service – that was new to
the organization at the time of adoption. Innovation is a practice, distinguished from
invention by its readiness for mass consumption and from other practices by its novelty.’
(Damanpour)
- ‘An innovation in health service delivery and organization is a set of behaviors, routines and
ways of working, along with any associated administrative technologies and systems, which
are:
o Perceived as new by a portion of stakeholders
o Linked to the provision or support of healthcare
o Discontinuous with previous practice
o Directed at improving health outcomes, administrative efficiency, cost-effectiveness,
or the user experience
o Implemented by means of planned and coordinated action by individuals, teams or
organizations
(Greenhalgh)
Different types of innovations
- Product innovation
Introduction of a good/service that is new or significantly improved with respect to its
characteristics or intended uses. This includes significant improvements in technical
specifications, components and material, incorporated software, user friendliness, or other
functional characteristics.
- Process innovation
The implementation of a new or significantly improved production or delivery method. This
includes significant changes in techniques, equipment and/or software.
- Marketing innovation
Implementation of a new marketing method involving significant changes in product design
or packing, product placement, product promotion and pricing.
- Organizational innovation
Implementation of a new organizational method in firm’s business practices, workplace
organization or external relations.
A technology is a design for instrumental action that reduces the uncertainty in the cause-effect
relationships involved in achieving a desired outcome. It has two components:
1) A hardware aspect
Consisting of the tool that embodies the technology as a material or physical object
2) A software aspect
Consisting of the information base for the tool
,Factors of innovations that are related to the success of innovations:
1) Relative advantage
The degree to which an innovation is perceived as better than the idea it supersedes. The
greater the perceived relative advantage of an innovation, the more rapid its rate of
adoption will be.
2) Compatibility
The degree to which an innovation is perceived as being consistent with the existing values,
past experiences, and needs of potential adopters. An idea that is incompatible with the
values and norms of a social system will not be adopted as rapidly as an innovation that is
compatible
3) Complexity
The degree to which an innovation is perceived as difficult to understand and use. Some
innovations are readily comprehended by most members of a social system; others are more
complicated and are adopted more slowly
4) Trialability
The degree to which an innovation may be experimented with on a limited basis. An
innovation that is trailable represents less uncertainty to the individual who is considering it
for adoption, as it is possible to learn by doing.
5) Observability
The degree to which the results of an innovation are visible to others. The easier it is for
individuals to see the results of an innovation, the more likely they are to adopt
6) Re-invention
The extent to which the innovation is changes or modified by the user in the process of
adoption and implementation
Other factors which should be involved in the development
process of an innovation:
- Recognizability
The target group must be able to identify with the
developers
- Representativeness
Related to the nature of the innovation and whether use
is made of the experience and expertise of those
stakeholders considered relevant to the clinical state
under consideration
- Expertise
The status enjoyed by the developers on the basis of
their expertise and authority also influences acceptance
A technology can create value at hospital level through:
- Creation of social value
The main issues related to social value creation are:
o The incremental level of efficacy/effectiveness
o The incremental level of patient or family’s satisfaction about the health services
delivered
- Creation of economic value
The main issues related to the economic value creation are:
o The increase of revenues
o The containment of running costs
- Creation of medical/technological knowledge
The main issues to be reviewed are:
, o The ability to develop new health services
o The ability to build up communities of knowledge or practice
The level of sustainability of technology adoption at hospital level can be related to:
- The financial/economic sustainability
Budget commute should understand the yearly impacts in term of running costs and cash out
because of technology adoption. The two issues are:
o Degree of self-funding
o Ratio of fixed costs to variable costs during the implementation stage
- The organizational sustainability
Can be realized by discussing the following issues:
o Technology coherence to strategic goals
o Technology acceptance among physicians
o Uncertainty in clinical practice
- The technological sustainability
Should be assessed against the features of both the technology under review and the
portfolio of technologies owned by the hospital. Main issues to be discussed:
o Technology life-cycle
o Technological coherence
- The resource sustainability
Should be reviewed against:
o Training intensity that is required to put the technology into routine
o Coherence to the human and physical resources
- The context sustainability
Copes with two main issues:
o Coherence to the current legal framework
o Coherence to the generally accepted ethics and systems of values
Four clusters of proposals for new technology adoption can be recognized:
- Target technology
Leads to relevant performance improvements,
because the investment is largely sustainable
- Mirage technology
Supposed to lead to relevant performance
improvements, but doubts that actual results
will differ from targets, because of a limited
capability to sustain the adoption
- Incremental technology
Leads to incremental performance
improvements, because the investment is largely sustainable.
- Resource-wasting technology
Leads to incremental improvement of performance, but there are clues that actual results
will differ from targets, because of a low level of sustainability.
Implementi ng innovati ons in healthcare
Case 1
Different definitions of innovation:
- ‘An innovation is an idea, practice, or object that is perceived as new by an individual or
other unit of adoption. It matters little, so far as human behavior is concerned, whether or
not an idea is objectively new as measured by the lapse of time since its first use of
discovery.’ (Rogers)
- ‘Innovation is the implementation of an internally generated or borrowed idea – whether
pertaining to a product, device, system, process, policy, program or service – that was new to
the organization at the time of adoption. Innovation is a practice, distinguished from
invention by its readiness for mass consumption and from other practices by its novelty.’
(Damanpour)
- ‘An innovation in health service delivery and organization is a set of behaviors, routines and
ways of working, along with any associated administrative technologies and systems, which
are:
o Perceived as new by a portion of stakeholders
o Linked to the provision or support of healthcare
o Discontinuous with previous practice
o Directed at improving health outcomes, administrative efficiency, cost-effectiveness,
or the user experience
o Implemented by means of planned and coordinated action by individuals, teams or
organizations
(Greenhalgh)
Different types of innovations
- Product innovation
Introduction of a good/service that is new or significantly improved with respect to its
characteristics or intended uses. This includes significant improvements in technical
specifications, components and material, incorporated software, user friendliness, or other
functional characteristics.
- Process innovation
The implementation of a new or significantly improved production or delivery method. This
includes significant changes in techniques, equipment and/or software.
- Marketing innovation
Implementation of a new marketing method involving significant changes in product design
or packing, product placement, product promotion and pricing.
- Organizational innovation
Implementation of a new organizational method in firm’s business practices, workplace
organization or external relations.
A technology is a design for instrumental action that reduces the uncertainty in the cause-effect
relationships involved in achieving a desired outcome. It has two components:
1) A hardware aspect
Consisting of the tool that embodies the technology as a material or physical object
2) A software aspect
Consisting of the information base for the tool
,Factors of innovations that are related to the success of innovations:
1) Relative advantage
The degree to which an innovation is perceived as better than the idea it supersedes. The
greater the perceived relative advantage of an innovation, the more rapid its rate of
adoption will be.
2) Compatibility
The degree to which an innovation is perceived as being consistent with the existing values,
past experiences, and needs of potential adopters. An idea that is incompatible with the
values and norms of a social system will not be adopted as rapidly as an innovation that is
compatible
3) Complexity
The degree to which an innovation is perceived as difficult to understand and use. Some
innovations are readily comprehended by most members of a social system; others are more
complicated and are adopted more slowly
4) Trialability
The degree to which an innovation may be experimented with on a limited basis. An
innovation that is trailable represents less uncertainty to the individual who is considering it
for adoption, as it is possible to learn by doing.
5) Observability
The degree to which the results of an innovation are visible to others. The easier it is for
individuals to see the results of an innovation, the more likely they are to adopt
6) Re-invention
The extent to which the innovation is changes or modified by the user in the process of
adoption and implementation
Other factors which should be involved in the development
process of an innovation:
- Recognizability
The target group must be able to identify with the
developers
- Representativeness
Related to the nature of the innovation and whether use
is made of the experience and expertise of those
stakeholders considered relevant to the clinical state
under consideration
- Expertise
The status enjoyed by the developers on the basis of
their expertise and authority also influences acceptance
A technology can create value at hospital level through:
- Creation of social value
The main issues related to social value creation are:
o The incremental level of efficacy/effectiveness
o The incremental level of patient or family’s satisfaction about the health services
delivered
- Creation of economic value
The main issues related to the economic value creation are:
o The increase of revenues
o The containment of running costs
- Creation of medical/technological knowledge
The main issues to be reviewed are:
, o The ability to develop new health services
o The ability to build up communities of knowledge or practice
The level of sustainability of technology adoption at hospital level can be related to:
- The financial/economic sustainability
Budget commute should understand the yearly impacts in term of running costs and cash out
because of technology adoption. The two issues are:
o Degree of self-funding
o Ratio of fixed costs to variable costs during the implementation stage
- The organizational sustainability
Can be realized by discussing the following issues:
o Technology coherence to strategic goals
o Technology acceptance among physicians
o Uncertainty in clinical practice
- The technological sustainability
Should be assessed against the features of both the technology under review and the
portfolio of technologies owned by the hospital. Main issues to be discussed:
o Technology life-cycle
o Technological coherence
- The resource sustainability
Should be reviewed against:
o Training intensity that is required to put the technology into routine
o Coherence to the human and physical resources
- The context sustainability
Copes with two main issues:
o Coherence to the current legal framework
o Coherence to the generally accepted ethics and systems of values
Four clusters of proposals for new technology adoption can be recognized:
- Target technology
Leads to relevant performance improvements,
because the investment is largely sustainable
- Mirage technology
Supposed to lead to relevant performance
improvements, but doubts that actual results
will differ from targets, because of a limited
capability to sustain the adoption
- Incremental technology
Leads to incremental performance
improvements, because the investment is largely sustainable.
- Resource-wasting technology
Leads to incremental improvement of performance, but there are clues that actual results
will differ from targets, because of a low level of sustainability.
