Capacity building in innovation adoption & procurement kt3 public version 2017

Capacity Building in Innovation Adoption & Procurement

oin the conversation!

@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

•

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

G

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

•

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

•

•

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?

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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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