scholarly journals Accelerating Innovation in Health Care: Insights From a Qualitative Inquiry Into United Kingdom and United States Innovation Centers

10.2196/19644 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e19644
Author(s):  
Kathrin Cresswell ◽  
Robin Williams ◽  
Narath Carlile ◽  
Aziz Sheikh

Background Digital health innovations are being prioritized on international policy agendas in the hope that they will help to address the existing health system challenges. Objective The aim of this study was to explore the setup, design, facilities, and strategic priorities of leading United Kingdom and United States health care innovation centers to identify transferable lessons for accelerating their creation and maximizing their impact. Methods We conducted qualitative case studies consisting of semistructured, audio-recorded interviews with decision makers and center staff in 6 innovation centers. We also conducted nonparticipant observations of meetings and center tours, where we took field notes. Qualitative data were analyzed initially within and then across cases facilitated by QSR International’s NVivo software. Results The centers had different institutional arrangements, including university-associated institutes or innovation laboratories, business accelerators or incubators, and academic health science partnership models. We conducted interviews with 34 individuals, 1 group interview with 3 participants, and observations of 4 meetings. Although the centers differed significantly in relation to their mission, structure, and governance, we observed key common characteristics. These included high-level leadership support and incentives to engage in innovation activities, a clear mission to address identified gaps within their respective organizational and health system settings, physical spaces that facilitated networking through open-door policies, flat managerial structures characterized by new organizational roles for which boundary spanning was key, and a wider innovation ecosystem that was strategically and proactively engaged with the center facilitating external partnerships. Conclusions Although innovation in health care settings is unpredictable, we offer insights that may help those establishing innovation centers. The key in this respect is the ability to support different kinds of innovations at different stages through adequate support structures, including the development of new career pathways.

2020 ◽  
Author(s):  
Kathrin Cresswell ◽  
Robin Williams ◽  
Narath Carlile ◽  
Aziz Sheikh

BACKGROUND Digital health innovations are being prioritized on international policy agendas in the hope that they will help to address the existing health system challenges. OBJECTIVE The aim of this study was to explore the setup, design, facilities, and strategic priorities of leading United Kingdom and United States health care innovation centers to identify transferable lessons for accelerating their creation and maximizing their impact. METHODS We conducted qualitative case studies consisting of semistructured, audio-recorded interviews with decision makers and center staff in 6 innovation centers. We also conducted nonparticipant observations of meetings and center tours, where we took field notes. Qualitative data were analyzed initially within and then across cases facilitated by QSR International’s NVivo software. RESULTS The centers had different institutional arrangements, including university-associated institutes or innovation laboratories, business accelerators or incubators, and academic health science partnership models. We conducted interviews with 34 individuals, 1 group interview with 3 participants, and observations of 4 meetings. Although the centers differed significantly in relation to their mission, structure, and governance, we observed key common characteristics. These included high-level leadership support and incentives to engage in innovation activities, a clear mission to address identified gaps within their respective organizational and health system settings, physical spaces that facilitated networking through open-door policies, flat managerial structures characterized by new organizational roles for which boundary spanning was key, and a wider innovation ecosystem that was strategically and proactively engaged with the center facilitating external partnerships. CONCLUSIONS Although innovation in health care settings is unpredictable, we offer insights that may help those establishing innovation centers. The key in this respect is the ability to support different kinds of innovations at different stages through adequate support structures, including the development of new career pathways.


Author(s):  
Peter Baldwin

The U.S. Economy does Differ from Europe’s: a less regulated labor market, but also an economy that is more hemmed in than might be expected. By European standards, America has hardish-working people, a state that collects fewer tax dollars, and workers who are paid well even if their holidays are short. In social policy, the contrasts are more moderate. Europeans commonly believe that the United States simply has no social policy—no social security, no unemployment benefits, no state pensions, and no assistance for the poor. As Jean-François Revel, the political philosopher and académicien, summed up French criticism, the United States shows “not the slightest bit of social solidarity.” Will Hutton similarly assures us that “The structures that support ordinary peoples’ lives—free health care, quality education, guarantees of reasonable living standards in old age, sickness or unemployment, housing for the disadvantaged— that Europeans take for granted are conspicuous by their absence.” And, in fact, the United States is the only developed nation, unless one counts South Africa, without some form of national health insurance, which is to say a system of requiring all its citizens to be insured in one way or another. This lack of universal health insurance is the one fact that every would-be comparativist working across the Atlantic knows, and the first one to be hoisted as the battle is engaged. One of the first attempts to quantify and rank health care performance, by the World Health Organization in 2000, gave the American system its due. Overall, it came in below any of our comparison countries, three notches under Denmark. In various specific aspects of health policy, it did better. For disability adjusted life expectancy, it came in above Ireland, Denmark, and Portugal; on the responsiveness of the health system, it ranked first; on a composite measure of various indicators summed up as “overall health system attainment,” it ranked above seven Western European countries. Even on the measure of “fairness of financial contribution to health systems,” where we might have expected an abysmal rating, the United States squeaked in above Portugal. That is, of course, damning with faint praise, especially given that in this particular aspect of the ranking—a well-meaning but other-worldly attempt by international bureaucrats to rake the entire globe over the teeth of one comb—Colombia came in first, outpacing its close rivals, Luxembourg and Belgium, while Libya beat out Sweden.


Author(s):  
Steven A. Demurjian ◽  
Alberto De la Rosa Algarín ◽  
Jinbo Bi ◽  
Solomon Berhe ◽  
Thomas Agresta ◽  
...  

In health care, patient information of interest to health providers, researchers, public health researchers, insurers, patients, etc., is stored in different locations via electronic media and/or hard-copy formats. All potential users need electronic access to health information technology systems such as: electronic health records, personal health records, patient portals, and ancillary systems such as imaging, laboratory, pharmacy, etc. Controlling access to information from multiple systems requires granularity levels of privileges ranging from one patient to a cohort to an entire population. In this paper, we present a viewpoint of the state of secure digital health care in the United States, focusing on the resources that need to be protected as dictated by legal entities and regulations, the available approaches in the present state-of-the art, and, the potential needs for the future of security for digital health care. By utilizing a real world scenario, the authors explore the limitations of health information exchange in the United States, and present one possible architecture for secure digital health care that builds on existing technology alternatives.


2017 ◽  
Vol 13 (6) ◽  
pp. e538-e542 ◽  
Author(s):  
Philip Savage ◽  
Sarah Mahmoud ◽  
Yogin Patel ◽  
Hagop Kantarjian

Purpose: The cost of cancer drugs forms a rising proportion of health care budgets worldwide. A number of studies have examined international comparisons of initial cost, but there is little work on postlicensing price increases. To examine this, we compared cancer drug prices at initial sale and subsequent price inflation in the United States and United Kingdom and also reviewed relevant price control mechanisms. Methods: The 10 top-selling cancer drugs were selected, and their prices at initial launch and in 2015 were compared. Standard nondiscounted prices were obtained from the relevant annual copies of the RED BOOK and the British National Formulary. Results: At initial marketing, prices were on average 42% higher in the United States than in the United Kingdom. After licensing in the United States, all 10 drugs had price rises averaging an overall annual 8.8% (range, 1.4% to 24.1%) increase. In comparison, in the United Kingdom, six drugs had unchanged prices, two had decreased prices, and two had modest price increases. The overall annual increase in the United Kingdom was 0.24%. Conclusion: Cancer drug prices are rising substantially, both at their initial marketing price and, in the United States, at postlicensing prices. In the United Kingdom, the Pharmaceutical Price Regulation Scheme, an agreement between the government and the pharmaceutical industry, controls health care costs while allowing a return on investment and funds for research. The increasing costs of cancer drugs are approaching the limits of sustainability, and a similar government-industry agreement may allow stability for both health care provision and the pharmaceutical industry in the United States.


2015 ◽  
Vol 10 (1) ◽  
pp. 161-164 ◽  
Author(s):  
John Walsh ◽  
Allan Graeme Swan

ABSTRACTThe process for developing national emergency management strategies for both the United States and the United Kingdom has led to the formulation of differing approaches to meet similar desired outcomes. Historically, the pathways for each are the result of the enactment of legislation in response to a significant event or a series of events. The resulting laws attempt to revise practices and policies leading to more effective and efficient management in preparing, responding, and mitigating all types of natural, manmade, and technological hazards. Following the turn of the 21st century, each country has experienced significant advancements in emergency management including the formation and utilization of 2 distinct models: health care coalitions in the United States and resiliency forums in the United Kingdom. Both models have evolved from circumstances and governance unique to each country. Further in-depth study of both approaches will identify strengths, weaknesses, and existing gaps to meet continued and future challenges of our respective disaster health care systems. (Disaster Med Public Health Preparedness. 2016;10:161–164)


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