Developing a sustainable Digital Health Innovation Ecosystem in a rural and resource-poor region: A monitored networking approach (Preprint)

BACKGROUND Digital health (DH) innovation ecosystems (IE) are key to the development of new e-health products and services. Within an IE, third parties can help promote innovation by acting as knowledge brokers and the conduits for developing inter-organisational and interpersonal relations, particularly for smaller organisations. Kolehmainen’s quadruple helix model suggests who the critical IE actors are, and their roles. Within an affluent and largely urban setting, such ecosystems evolve and thrive organically with minimal intervention due to favourable economic and geographical conditions. Facilitating and sustaining a thriving DH IE within a resource-poor setting can be far more challenging even though far more important for such peripheral economics and the health and well-being of those communities. OBJECTIVE Taking a rural and remote region in the UK, as an instance of an IE in a peripheral economy, we adapt the quadruple helix model of innovation, apply a monitored social networking approach using McKinsey’s Three Horizons of growth to explore: • What patterns of connectivity between stakeholders develop within an emerging digital health IE? • How do networks develop over time in the DH IE? • In what ways could such networks be nurtured in order to build the capacity, capability and sustainability of the DH IE? METHODS Using an exploratory single case study design for a developing digital health IE, this study adopts a longitudinal social network analysis approach, enabling the authors to observe the development of the innovation ecosystem over time and evaluate the impact of targeted networking interventions on connectivity between stakeholders. Data collection was by an online survey and by a novel method, connection cards. RESULTS Self-reported connections between IE organisations increased between the two waves of data collection, with Small and Medium-sized Enterprises (SMEs) and academic institutions the most connected stakeholder groups. Patients involvement improved over time but still remains rather peripheral to the DH IE network. Connection cards as a monitoring tool worked really well during large events but required significant administrative overheads. Monitored networking information categorised using McKinsey’s Three Horizons proved to be an effective way to organise networking interventions ensuring sustained engagement. CONCLUSIONS The study reinforces the difficulty of developing and sustaining a DH IE in a resource-poor setting. It demonstrates the effective monitored networking approach supported by Social Network Analysis allows to map the networks and provide valuable information to plan future networking interventions (e.g. involving patients or service users). McKinsey’s Three Horizons of growth-based categorisation of the networking assets help ensure continued engagement in the DH IE contributing towards its long-term sustainability. Collecting ongoing data using survey or connection card method will become more labour intensive and ubiquitous ethically driven data collection methods can be used in future to make the process more agile and responsive.