Capacity Building in Innovation Adoption & Procurement
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@WIN_Health
November 22, 2017
Anne Snowdon, Renata Axler, Carol Kolga, Ryan DeForge, Melissa St. Pierre, Courtney Williston, Joan Craig, Deborah Tallarigo 1
The Innovation Adoption Process Model Diffusion, Scaling & Widespread Adoption Implementation & Early Adoption
Health System Priorities & Needs
Partnership Development & Stakeholder Engagement R&D for Innovati ve Solutions
Pilot Test
Prototyp e
Leadership & Organizational Culture
Innovation Procurement Process Identifying Health System Priorities • Creates the demand-pull for innovators
Identifying a Procurement Model • Chosen based on organizational structure and needs
Early Market Engagement • Active engagement of small companies and a consideration of outside vendors
Innovation Procurement Process
• Competitive dialogue, design contest, other
Solution Implementation and Early Adoption • Contracts awarded or pilot tested
Evaluation • Multi-stakeholders participate in evaluation including clinicians and patients to contribute to evaluation of products, services, partnerships, and relationships
Qualitative Case Study Methodology • Key informant interviews • Document reviews, site visits (when appropriate) • Interviews are coded to surface common themes within & across cases • Themes are supported by key quotations from the interview data • All data are anonymized
Spectrum of Innovation HEALTH
EDUCATION
Medical devices (5)
Patient engagement platforms (3)
Curricular supports & assessment tools (4)
Simulations (2)
Telemedicine & remote patient monitoring (3)
“Smart� hospitals & communication tools (2)
Pedagogy & teacher development solutions (2)
Assistive solutions (2)
Assessment tool (1)
Student engagement platforms (2)
Leadership
Successful Partnerships Alignment & Fit
Absorptive Capacity
Emerging Findings from WIN Case Study Research: Innovation Adoption in Healthcare Strategies for Scaling
Surfacing Value
Real-world Conditioning
Balancing Flexibility & Scope Management
Alignment & Fit •
Solution alignment with system needs and priorities facilitates innovation adoption
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Alignment engenders a shared resolve to address challenges
Alignment & Fit •
Inter-organizational fit and synergy in “cultures of innovation” facilitates adoption
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Fit with existing processes and workflows is a requisite of successful innovation adoption
Leadership •
Especially within inter-organizational partnerships
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Developing a supportive environment by being present
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Providing organizational structure and lending influence to create conditions for success •
Exploring options
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Effective governance and communication
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Leveraging the leadership of others
Cohesive and Collaborative Partnerships The commitment to collaborate and iteratively find the solutions to problems and challenges
Absorptive Capacity Organizational level: the (in)ability of an organization to resource/manage/commit to an innovation/initiative Behavioral level: the (in)ability for patients to remain engaged throughout the entire course of a demonstration project
Absorptive Capacity •
Can be challenging in busy organizational settings, where competing priorities abound
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Absorptive capacity of end-users is also important, requiring a focus on usability and integration
Vendors: Balancing Flexibility with Scope Management •
Vendor flexibility and adaptability is an asset to healthcare organizations
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Managing the scope of work that drives the adoption of innovation is equally important
scope management flexibility
Real-world Conditioning •
The value of experiential, tacit and practical knowledge gained through deployment of the innovative solution in real-world (rather than laboratory/RCT) settings
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Dependent on: •
Feedback channels and effective communication among all project partners
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Workflow mapping to tailor solutions to settings
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Practical knowledge and surfacing real-world insights
Strategies for Scaling •
Create / demand real-world (real-Ontario) evidence •
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Challenging to embed/scale without evidence of impact
Site-to-site, word of mouth diffusion SC
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Create and pilot solutions with “stickiness” - end users won’t want to give up use
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Modular growth: units of software solution per region
IN
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Strategies for Scaling •
Expand and extend the number of use cases •
“Innovation drift”
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Demonstration of impact in new areas
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Scale outside of Canada
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Partnering from the outset to scale
SC
IN
AL
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Surfacing Value | Value vs Cost The (in)ability to surface value – to understand how it varies in a particular context, to present an innovative solution in terms of value propositions, to measure impact and value – can accelerate (impede) partnership development and broader, widespread adoption.
Surfacing Value • •
• •
In research pilots
To demonstrate impacts
From a Vendor of Record
Scalability built into partnerships
Addressing urgent, critical needs
Building it out
Shared philosophies
Leadership endorsement
Emerging Findings from WIN Case Study Research: Innovation Adoption in Clinician Engagement Education
Charting a course to scaling Unclear & vague processes Evidence of impact
Sandbox environments Early Engagement Low barrier to get started
“[The solution] addresses an urgent, critical learning need” •
Solution meets end-user needs
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Innovation is aligned with ON K-12 curriculum
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Addresses priorities identified by the Ministry
Trust: “That philosophy, that sharing of it” •
Leveraging pre-existing partnerships
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Alignment of expectations, goals, and values
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Partner responsiveness to queries and concerns
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Partnerships with system-level education leaders
Leadership endorsement •
Endorsement from senior leadership may be critical to creating momentum and engaging teachers
“Vague and unclear” institutional processes •
Process of getting innovation into school boards not well understood
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Uncertainty around school board Research Ethics timelines and requirements
Sandbox environments •
Strong culture of innovation at some K-12 and post-secondary institutions
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Presence of innovation hubs & incubators •
Creating a “sandbox” for technology innovation, use, and evaluation
Customizability: “If we don’t build it out, this product won’t work” •
Solution can be customized to meet specific end-user needs
•
Investments in solution customization are considered essential by vendors for longterm success
Accessibility: “Low barrier to get started” • Solution is easy to access, and has a user-friendly interface • Solutions have low barriers to use
Creating evidence of impact • Creating evidence of impact may fuel further adoption • Program and process evaluations can yield endorsements and evidence for adoption across organizations
Charting a course to scaling •
Planning for scaling can involve looking for opportunities within institutions •
•
Across departments/ disciplines
Planning for scaling across institutions is also at the forefront for some companies •
Across school systems, internationally
Flexibility In Process
Vendors as Partners
Expertise Capacity
Emerging Findings from WIN Case Study Research:
Evidence of Impact
Evaluation Challenges
Innovation Procurement
Early Engagement
Resource Intensiveness
Co-Creating Solutions
Key Features of Innovation Procurement •
Attention to value in procurement, understood broadly, beyond financial/cost value
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Focuses on outcomes, rather than technical specifications o Desired outcomes are defined, but functional/technical solution specifics are not; allows for innovation and creativity to create the desired outcome
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Facilitates fair, accountable, transparent dialogue between vendors and purchasers o Purchasers learn about market solutions, vendors learn system needs
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Value-focused innovative procurement o Focuses on improving patient outcomes while controlling costs through purchasing innovative solutions for health care system
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Value = health outcomes/cost of delivering these outcomes
Using Demonstration Projects to Identify Best Practices for Innovation Procurement What we still don’t know • Impact on innovation & value • Impact on vendors & public sector organizations • (Long term) return on investment, and how to measure this
What we know matters • Early and genuine market engagement • Clear statement of need/ outcomes • Flexibility, collaboration • Organizational culture & leadership
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Innovation Procurement and the BPS Procurement Directive: “Following the Rules”
Teams that have undertaken Innovation Procurement processes did so within the scope of the Broader Public Sector Procurement Directive – in a fair, open, and transparent way, that also enabled creativity and innovation Innovation procurement can “challenge the myths” of procurement
Expertise Capacity: “There’s (often) no road map” • Procurement teams embarking on Innovation Procurement processes often have limited knowledge on how to execute an Innovation Procurement project • Teams need to educate themselves on innovation procurement processes • Early innovation procurement processes in Ontario are creating the roadmap for more widespread innovation procurement initiatives
Flexibility and openness of process: “It’s making that leap” • Innovation Procurement processes need to be negotiated, there is a need to be flexible in creating these processes • Innovation procurement represents a leap of process and mind space, and letting go of preconceived notions of procurement processes
Resource Intensiveness: “It’s High Effort” • Innovation Procurement is resource intensive and requires teams to implement it, highlighting the importance of teamwork and collaboration
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The Value of Vendor Engagement • Vendor engagement adds value for both vendors and procuring organizations, and helps to enable a focus on outcomes rather than products • Inclusion of smaller vendors allows them to be part of conversations they have not been in the past
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Valuing Vendor Engagement • Vendors who participate in engagement activities must be respected for their time and input • Information gathered through market engagement activities should be used in a timely manner in order to accurately reflect the state of the technology market
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Engaging Vendors as Partners • Innovation Procurement enables the engagement of vendors as partners in procurement processes, rather than just suppliers of products • Innovation procurement allows for an assessment of partnerships with vendors and long-term collaborative relationships
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Building Solutions With Vendors • Innovation procurement can enable the co-creation of solutions with vendors, demonstrating a more equal purchaser-supplier relationship • Yet, it’s important for both vendors and procuring organizations to define and understand what co-designing solutions means to them
The Value of Stakeholder Engagement •
Engaging Stakeholders in procurement processes is key, but questions remained about how, when, and where to best engage them •
Value in clinician, patient, user involvement in evaluating technologies
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Engaging users also helps to define requirements upfront
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Evaluation Challenges: Comparing Apples to Oranges •
Use of outcomes based specifications can yield high variability in proposals, and evaluators may need to determine the effectiveness of different solutions to adequately assess responses
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Creates challenges for templates that can fairly evaluate diverse submissions
Evidence of Impact •
Teams that have undertaken innovation procurement projects have, to date, seen considerable positive outcomes •
Significant financial value generated
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Partnerships with small or unexpected vendors
What about Scaling? •
Scalability strategies for procured technologies should be built into innovation procurement processes to maximize value and scale
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“Opt-in” options for other jurisdictions, once value has been proven.
Thank You Contact: Dr. Anne Snowdon, Academic Chair, WIN Anne.Snowdon@uwindsor.ca
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