Knowledge Translation Emerging Findings: Innovation Adoption and Procurement

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Knowledge Translation Emerging Findings: Innovation Adoption & Procurement Join the conversation!


Dr. Anne Snowdon, Academic Chair Dr. Renata Axler, Research Associate Dr. Ryan T. DeForge, Research Associate Carol Kolga, Senior Research Associate 1 Dr. Phillip Olla, Senior Researcher Dr. Melissa St. Pierre, Research Associate

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 2

Overview of KT Workshop #2

• Objective #1: Key enablers & barriers of innovation adoption; key conditions for successful adoption that may support scalability • Objective #2: Key conditions for successful innovation procurement; challenges & strategies to overcome those challenges • Objective #3: Reflect on, & discuss stakeholder engagement • Objective #4: Reflect on, & discuss the concept of value 3

Innovation Adoption 4

The Innovation Adoption Process Model Diffusion, Scaling & Widespread Adoption Implementation & Early Adoption

Health System Priorities & Needs

Partnership Development & Stakeholder Engagement R&D for Innovative Solutions

Pilot Test


Leadership & Organizational Culture


Leadership & Organizational Culture • Senior leaders must all be on board; • Projects with limited-duration funding can sometimes be neglected by leaders


Identifying the Problem: Health System Priorities & Needs •

Health systems more apt to adopt products with good service models

Partnership Development

• When clinical teams and vendors always have a rep available for teleconferencing, collaboration and support increase • When vendors are treated as partners, they can give feedback on how health systems and clinical teams can leverage key parts of their products to provide better solutions

Stakeholder Engagement

• Engagement with clinicians: When front-line staff are working with a co-design team, then both parties feel more invested in the success of the product


R&D for Innovative Solutions •

Feedback from clinicians: You’re not just trying to make a sale by getting them interested: Clinician feedback helps to improve the product to suit clinical needs

Prototype •

Early adopters are keen: Their buy-in is correlated with the value they see the product enables for their practices

Pilot Test •

Even minor technology glitches or ease-of-use problems lead to lower product evaluations when vendors do not respond quickly to fix or address these

Implementation & Early Adoption •

Issues of responsibility for and capacity to create evidence of impact must be addressed


What, Why and How of Innovation Procurement 9

Overview WHAT is innovation procurement? WHEN & WHY might it be used? HOW can it be done well?

What are the enablers & challenges of innovation procurement?


What is Innovation Procurement?

Attention to value in procurement

Understood broadly, beyond financial/cost value

Uses Outcomes Based Specifications (OBS)

Desired future state (or outcomes) are defined, but functional/technical solution specifics are not Allows for innovation and creativity to meet outcomes

Facilitates fair, accountable, transparent dialogue between vendors and purchasers 11

Models of Innovation Procurement – Vendor Engagement Market Sounding

Document is released to the entire market seeking information and feasibility of a solution to be procured

Vendor Engagement

Vendors are invited (in-person) to meet with the procuring organization to discuss the state of the market, the art of the possible, and partnership opportunities.

Trade shows, reverse trade-shows, hackathons, etc.

Procuring organizations engage with a number of vendor teams to demonstrate solutions available on the market, or prototypes of potential solutions

Models  of  Innovation  Procurement Competitive Dialogue

Vendors are pre-qualified to participate in the dialogue. Vendors dialogue with purchasers to maximize value and meet the needs of the procuring organization in their proposals

Design Contests/Phases

Vendor applicants iteratively design a solution to meet the needs of the purchasing organization. The winner is chosen based on the quality of their design and their modes of working

Innovation Partnership

Vendors engage in a partnership with the procuring organization to co-create a solution that meets the needs of the procuring organization and the users of the technology

When Should Innovation Procurement be Used?

For complex solutions When no solution on the market exists

Ability to co-create a solution with vendors Work with vendors outside the traditional healthcare market

When there’s uncertainty around what specific product is being sought Allows vendors to design solutions to meet needs and produce value

Why Should Innovation Procurement be Used? Enables innovation! It is BPS Directive compliant Produces value for organizations and payers Draws from the unique knowledge of the vendor market Enables evaluation beyond written RFP requirements You may end up with something you never imagined

Enablers of Successful Innovation Procurement

Organizational culture

Supportive of innovation and new procurement models

Leadership & support

Design and implementation of procurement strategy Learning from successes of other organizations, engaging experts

Alignment of procurement initiative with need Health system or policy need

Enablers of Successful Innovation Procurement

Early (and genuine) market engagement

Active engagement of small companies Considering vendors outside the healthcare arena

Ability to evaluate what matters

Clinician engagement in evaluation? Patient engagement in evaluation? Evaluating partnerships and relationships

Challenges to Successful Innovation Procurement

Resourcing and scheduling

Resource intensive process Bringing together internal project team members/evaluators can be challenging

Lack of internal innovation procurement expertise External expertise and resources may be required

(For vendors) High investments with no guaranteed payoff Vendor engagement activities are time consuming, especially challenging for start-ups

Challenges to Successful Innovation Procurement

Evaluating significantly different proposals “Comparing apples to oranges� Difficulty in evaluating pricing models

Questions around IP

Who owns the IP in a co-created solution?

Translating open procurement into a specified contract and SOW Requires accountability and specific roles & responsibilities in the contract

Stakeholder Engagement 20

Stakeholder Engagement

-Leadership Vision

- Vendor vs Partner

-KOL Buy-in

- Lack of Internal Knowledge

-Clinical input

Engagement Capacity

-­â€?Leadership time Commitment

- Resources (funds)

-Culture of Innovation

-Measurement Expertise & Impact

-Team Approach

-Tech Integration

Health System

Innovation Partner

Sustainability: Thinking Beyond the Demonstration Project

RFP Partners Fit Reimbursement IP

Communication • Minimizing uncertainty • Clear roles, responsibilities, accountabilities • Communication within and among project (sub)teams • Steering and Advisory Committees

Partnering to foster & lead a culture of innovation • Hospital system leadership • Strong culture of innovation • Organizational support / mission alignment • Executive leadership vision

• Strong culture of innovation (Focused personnel [Director of Research, Project Lead] to manage the project, engage leadership and vendor community • Strong project governance • Regular meetings with leadership and/or steering committee drive projects forward

• Engaging Key Opinion Leaders and “luminaries in the field” in co-design and as early adopters.

• Customers as partners with shared vision; • when customers don’t see vendors as partners, they don’t gain as much feedback regarding the capacities of the product

• Good communication between teams

• Importance of always having a rep available for teleconference

• Resource Constraints

• Efficiency critical, as vendors are managing multiple projects at once

• Staff Buy-in to the Value of the solution

• Leadership should solicit feedback from front-line staff regularly to ensure needs (e.g., workflow, decisionmaking) are being met by product

• Clinical Change Agents

• Staff, young adopters are keen when/if can see tech enable their practices

The Concept of Value 27

Surfacing Value in Innovation Adoption and in Innovation Procurement What do we mean by “value”? A quality based on a person’s principles or standards, one’s judgment about what is valuable and important in life, and what a person deems important. Value Propositions for Patient, Clinician team, Organization, System Patients value access, improved health outcomes, positive experience Clinical teams value workload efficiencies, improved effectiveness Healthcare organizations value patient flow, cost Healthcare systems value quality (error, performance), cost The inability 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 – can impede partnership development and broader, widespread adoption.


Surfacing Value in Innovation Adoption and in Innovation Procurement • • • • • • • •

The inability to assess total value The tendency to favor acquisition costs over total cost / downstream savings Creating value and benefit (especially for clinicians) The value of early market engagement (pre-procurement) The value a design contest offers to assessing fit How Competitive Dialogue can surface value Value of using open, outcomes based specifications to surface value The value of gaining experience in (resource-intensive) innovation procurement 29

Thank You Dr. Anne Snowdon, Academic Chair, WIN Dr. Renata Axler, Research Associate Dr. Ryan T. DeForge, Research Associate Carol Kolga, Senior Research Associate Dr. Phillip Olla, Senior Researcher Dr. Melissa St. Pierre, Research Associate Find us online at: Follow us on Twitter: @WIN_Health Like us on Facebook: World Health Innovation Network Follow us on LinkedIn: World Health Innovation Network Subscribe to us on YouTube: WIN Health