Criteria to assess potential reverse innovations: opportunities for shared learning between high- and low-income countries

Abstract

BackgroundLow- and middle-income countries (LMICs) are developing novel approaches to healthcare that may be relevant to high-income countries (HICs). These include products, services, organizational processes, or policies that improve access, cost, or efficiency of healthcare. However, given the challenge of replication, it is difficult to identify innovations that could be successfully adapted to high-income settings. We present a set of criteria for evaluating the potential impact of LMIC innovations in HIC settings.MethodsAn initial framework was drafted based on a literature review, and revised iteratively by applying it to LMIC examples from the Center for Health Market Innovations (CHMI) program database. The resulting criteria were then reviewed using a modified Delphi process by the Reverse Innovation Working Group, consisting of 31 experts in medicine, engineering, management and political science, as well as representatives from industry and government, all with an expressed interest in reverse innovation.ResultsThe resulting 8 criteria are divided into two steps with a simple scoring system. First, innovations are assessed according to their success within the LMIC context according to metrics of improving accessibility, cost-effectiveness, scalability, and overall effectiveness. Next, they are scored for their potential for spread to HICs, according to their ability to address an HIC healthcare challenge, compatibility with infrastructure and regulatory requirements, degree of novelty, and degree of current collaboration with HICs. We use examples to illustrate where programs which appear initially promising may be unlikely to succeed in a HIC setting due to feasibility concerns.ConclusionsThis study presents a framework for identifying reverse innovations that may be useful to policymakers and funding agencies interested in identifying novel approaches to addressing cost and access to care in HICs. We solicited expert feedback and consensus on an empirically-derived set of criteria to create a practical tool for funders that can be used directly and tested prospectively using current databases of LMIC programs.

Global Lessons In Frugal Innovation To Improve Health Care Delivery In The United States

“…Data Collection Before commencing the data collection phase, the Institute of Global Health Innovation and Innovations in Healthcare convened in North Carolina in March 2015 to devise our search, identification and evaluation methodology.We used an emergent-search methodology guided by the definitions of frugality 2,3,24,25 and reversibility 18,26 drawn from the existing literature and previous empirical studies (for details about our methodology, see online Appendix Exhibit A1). 27 We used Everett Rogers's definition of innovation-"an idea, practice, or object that is perceived as new by an individual or other unit of adoption" 28 -with particular emphasis on adoption across regions, as the indicator of successful scaling.…”

“…But at the same time, Henry Chesbrough 17 and other proponents of open innovation 12 argue that external knowledge sources can lead to increased opportunities for inspiration, relevance, and value creation and to reduced costs of research and development. There is a growing momentum to facilitate open innovation, which has led to the development of sourcing models 18 and databases of health care innovations around the world, such as the Center for Health Market Innovations and the World Innovation Summit for Health 2016 Innovation Showcases.…”

The search for the holy grail: frugal innovation in healthcare from low-income or middle-income countries for reverse innovation to developed countries

“…In prior work, we attained an inter-rater agreement in excess of 70% in using our frugal assessment tool (see Prime et al 19 for further information). Between April and May 2015, we then tested, revised and applied a reverse innovation assessment tool from the Toronto Health Organization Performance Evaluation (T-Hope) group,20 to settle on 27 cases that were both frugal and had potential to be transferred to the USA, which we deemed to have the greatest relevance and potential to be diffused into the US healthcare market. Criteria included need, novelty, receptivity and compatibility with regulation and infrastructure.…”

Review of the reverse innovation series in globalization and health – where are we and what else is needed?

“…This threat to scientific universalism has been evidenced in other robustly controlled experiments [18]. Also included have been articles that provide tools to support the identification and translation of innovations from LICs into HICs [19]. Ouma et al [20] provide insights into how Reverse Innovation is experienced from the perspective of the LIC partner, with suggestions for how to develop mutually beneficial partnerships in the long term.…”