(an extract from the book Mission Possible)
The relatively slow penetration and slow adoption of technology (we are talking mainly about IT here) in healthcare is partly due to regulatory barriers and partly due to the complexity inherent to healthcare. If technology has to penetrate healthcare, then a protected sandbox for prototyping new products is necessary. The government should create these sandboxes by earmarking premier government healthcare institutions, like the AIIMS institutions, as places where controlled experimentation on new health tech innovations can be undertaken. The sandbox environment should have a soup-to-nuts approach to facilitate each step of the innovation process. The model we propose below has the potential to make India a world-beating leader in the development and deployment of technology solutions in healthcare.
As we have highlighted earlier the development, dissemination, and large-scale adoption of health tech have been hampered by (1) the lack of standards, resulting in a fragmented marketplace, (2) low and slow adoption by healthcare providers, who are reluctant to replace legacy systems and processes, (3) Ethical and regulatory issues that surround the
development of healthcare innovations that directly impact the lives and privacy of consumers, (4) A tragedy of the commons, since the benefits of health tech implementation largely accrues to the Government and consumers, and not to private players. Health, and by inference the health tech sector, is like telecom where the Government has a key regulatory role to play. But beyond the role of the Government as a rule-maker, we also envisage a key role for the Government as coordinator and catalyst for health tech innovation. The Government can level the playing field for innovation creating scope for
competitive forces to ensure that the best solutions are curated, keeping the interests of healthcare consumers in mind.
We propose an innovation model that has the potential to make India a leader in the development and commercialization of health tech globally. Such leadership will not only benefit Indian patients and the Indian economy but can also become a huge export industry that combines products and services. The model we propose will, in one
stroke, eliminate the common barriers that retard the development of health technologies as mentioned above.
The core of the model we propose consists of what we call Health-tech Innovation Parks (HIPs). These Innovation Parks will co-localize, both physically and organizationally, health tech companies, hospitals, clinics, mobile- and tele-health providers, regulatory agencies (IT, Health IT, Healthcare), medical research organizations, medical training/teaching
institutes (like the AIIMS), ethics bodies, and the Clinical Trials regulator, Start-up companies, Investors, and International Collaborators. These parks will be safe spaces where new technologies can be deployed under controlled conditions, in compliance with the regulations that govern their experimental prototyping and testing. Such studies will be
monitored, and the outcomes evaluated by independent experts who will evolve standards that can help in the progressive development of technologies. The process will ensure the development of technological solutions optimized for scalability. There is room for more than one HIP, with each HIP leveraging the strengths of local regions and specializing
in specific technological domains, e.g. medical devices or robotics or AI/ML.
The innovation process in the HIPs should incorporate the methodology of design thinking. Design thinking prioritizes deep empathy for end-user desires, needs, and challenges to fully understand a problem. Such an approach helps develop comprehensive and effective
solutions. Empathetic engagement with patients and their needs is the starting point. Two other elements of the design thinking process as applied to healthcare are radical collaboration and rapid prototyping.
Radical collaboration recognizes the fact that “health problems exist across and at the intersections of disciplines and sectors, not within them”. Patients, nurses, doctors, engineers, automation specialists, managers, technicians, and product development specialists have to collaborate to come up with robust and practical solutions. Design
thinking also mandates “rapid prototyping”. The advantage of combining “rapid prototyping” with “radical collaboration” is the opportunity to test prototypes across diverse stakeholders and get real-world insights that an help design solutions that work in the real world and not just in the laboratory. Quoting from a paper by Roberts and colleagues (2016): “Much of the skepticism and frustration linked to the scale and pace of change
and innovation within the current health system stems not from a lack of vision, effort, or even resources; rather it arises from attempts to remake a healthcare model never designed to do the things now being asked of it.
We argue that expanded capacity for and application of design thinking approaches within healthcare can help drive necessary innovation in care delivery models. There is no single ‘right’ or easy answer to the challenges healthcare faces now and in the future, but the design thinking framework offers an accessible and recognizable approach for discovering, developing, and delivering services (both old and new) that align with individual and community needs”.
Since design thinking would need co-location of the designers with the users (patients and HCWs), the HIP would provide the optimal conditions and locations to offer a tightly iterative process of do-learn-do that can produce superior solutions than those that are developed using more loosely integrated innovation practices. If the HIP is the Y-shaped
wooden piece in a slingshot, then design thinking can be imagined as the elastic band that launches the missile (innovations) into action.
Health Innovation Parks can have a broad scope, offering a test bed for new health technologies, ranging from pure IT solutions to automation solutions/robotics and medical technologies. HIPs and the companies that run projects in the HIPs can be provided loans, tax incentives, and other privileges during the development phase. HIPs can invite partnerships with countries like Singapore, which do not have the population size needed for the rapid testing of new technologies.
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