The adoption and diffusion of value-adding innovation is essential in our quest to not only improve health outcomes and quality, but also to ensure we adopt a cost-effective approach to healthcare delivery during challenging economic times.
It is not remiss to state that in innovation lies the quality and financial gain our health systems face today. Viewed through that lens, you begin to see innovation not as icing on the cake, but core components of our health services.
So what are our healthcare challenges? Succinctly put, the economic pressures are consequent to an ageing population, an increasing acuity of patients presenting to GPs and hospitals, increasing patient demand and an increasing pressure to fund a wider portfolio of health services. These pressures must be confronted.
Clearly IT enables better communication between healthcare providers when used well, but the multiplicity of IT solutions in the current NHS limits the true potential of IT to improve patient-centred care across healthcare providers.
Identifying innovation is a key factor in addressing the economic challenge of any evolving health system
Solving the IT challenge is only one objective in terms of improving healthcare. Improving quality, productivity, efficiency and prevention are all essential too. Identifying innovation, whether it is incremental or disruptive, is a key factor in addressing the economic challenge of any evolving health system.
And adopting innovation must overcome any barriers to implementation, be they due to short-term vision, lack of time or money or any other functional impediment. The health system must commence adoption with integrated planning between those charged with funding and those delivering healthcare.
In the NHS, this translates as commissioner and provider, a split which left to its own devices may lead to perverse incentives acting as a barrier to implementing innovative activity, an example being that if hospitals are paid for delivering quotas of face-to-face patient follow-up, why would they disinvest in that to deliver telehealth consultations at lower income? Having implemented the remote follow-up of pacemaker patients at Sandwell and West Birmingham NHS Trust, it was clear to me that current reimbursement constraints prohibit the implementation of remote follow-up of pacemaker patients.
We must define tariffs and then incentivise providers to deliver what, in effect, is a quality improvement measure which might also save cost. Concepts such as gain sharing, that is sharing the proceeds of cost savings from innovation implementation, are key to successful adoption and diffusion. Coupling integrated planning with co-ordinated delivery and divided responsibility for implementation by both providers and commissioners will catalyse innovation.
To avoid adoption of innovation being labyrinthine, as well as addressing reimbursement impediments, the NHS must address up-stream investment to catalyse a change which alters patient outcomes.
At a time of scarce resource, you could argue that innovation is precisely the area where we should be investing in order to fertilise future gains. We must be smart about identifying key innovations and developing strategies to plan and deliver innovation.
Importantly for the public sector, any cost savings might actually fund the up-stream investment. Most important, however, and key to driving innovation is leadership, essential to defining a culture which promotes and fertilises progress. Such leadership must inspire, support, enable and reward innovation.
Kiran Patel is a consultant cardiologist at Sandwell and West Birmingham NHS Trust, and an honorary senior lecturer at Birmingham University.