​The UK is one of the leaders in innovation globally; one of the most prolific countries in terms of producing new knowledge and inventions.   But it is nowhere near on the uptake of these inventions and bringing them to practice, compared to other leading countries.   “Many other countries face challenges in closing the gap between what we know, and what we do,” said Lord Darzi, Paul Hamlyn Chair of Surgery at Imperial College of London.

Speaking at SingHealth Academic Hour on 11 February, Lord Darzi talked about global diffusion of healthcare innovation and how health systems can change to support it.   He said, “Innovation is about applying a new technology, process, or business model that creates value. That is very separate in our ability to create new knowledge/inventions.   They are two sides of the same coins.”

A lot of innovation and discoveries will go through the pipeline. Lord Darzi warned that “the most important thing is the translational ability from discovery to evidence. And when you already have evidence – how many clinicians are translating it to practice?

“When a new drug has been approved for use, there is still the challenge of penetrating the population for it to have an impact. The effort and money spent may go to waste if diffusion doesn’t happen.”

Enablers and cultural dynamics

Lord Darzi and his team at Imperial College London’s Institute of Global Health Innovation conducted a study to better understand what can be done to adopt innovation and contribute to system transformation. The framework lists elements in cultural dynamics such as adapting innovations to local context and eliminating old and ineffective ways of working.   It also lists enablers, including incentives and reward (not necessarily monetary), communication across healthcare and standards and protocols that are quick to adapt according to new evidence.

However, despite differences in enablers from country to country, there are common front line cultural dynamics: supporting champions, engaging patients and engaging clinicians.

“The experts confirmed that the diffusion of innovation is largely about winning the hearts and minds of those working on the front line,” said Lord Darzi.

Frugal is not cheap

In many countries innovation can be seen as added cost, but innovation does not have to be expensive. Lord Darzi asked the audience to return to the definition of innovation: “It is about improving access, improving quality and reducing cost.” –
Hence the important concept of frugal innovation: innovation that is world-class in quality, results in significant price reduction, is scalable in many locales and circumstances and can be affordable at the bottom of the socio-economic pyramid.

Frugal innovation in India has reduced cardiac surgery costs to a 10% of what it is in the US, while keeping excellent quality outcomes.   In Ryhov Hospital, Sweden, 40% of patients self-administer hemodialysis, reducing labour costs and increasing satisfaction. In Mexico, more than one million households pay US$5 per month to access health advice via their cell phones without having to set foot in a physician’s office.

These are just some examples of successes driven by the four principles of frugal innovation:
1. Constraints: make do with what is available
2. Systems thinking
3. Economies of scale: what’s designed needs to be scaled up
4. Need awareness: the clinical community has to understand the needs of the population

Lord Darzi closed the session by quoting Charles Darwin: “It is not the strongest of the species that survives, not the most intelligent, but the most adaptable to change.”

Watch Highlights of Lord Darzi's talk on Tomorrow's Medicine YouTube Channel