Imperial College London


Faculty of MedicineDepartment of Surgery & Cancer

Honorary Lecturer



yasser.bhatti Website




Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus





Publication Type

11 results found

Prime M, Attaelmanan I, Imbuldeniya A, Harris M, Darzi A, Bhatti Yet al., 2018, From Malawi to Middlesex – The case of the Arbutus Drill Cover System as an example of the cost saving potential of frugal innovations for the UK NHS, BMJ Innovations, Vol: 4, Pages: 103-110, ISSN: 2055-642X

Background Musculoskeletal disease is one of the leading clinical and economic burdens of the UK health system, and the resultant demand for orthopaedic care is only set to increase. One commonly used and one of the most expensive hardware in orthopaedic surgery is the surgical drill and saw. Given financial constraints, the National Health Service (NHS) needs an economic way to address this recurring cost. We share evidence of one frugal innovation with potential for contributing to the NHS’ efficiency saving target of £22 billion by 2020.Methods Exploratory case study methodology was used to develop insights and understanding of the innovations potential for application in the NHS. Following a global search for potential frugal innovations in surgery, the Arbutus Drill Cover System was identified as an innovation with potential to deliver significant cost savings for the NHS in the UK.Results The Arbutus Drill Cover System is up to 94% cheaper than a standard surgical drill available in the UK. Clinical and laboratory tests show that performance, safety and usability are as good as current offerings in high-income countries and significantly better than hand drills typically used in low-and-middle-income countries. The innovation meets all regulatory requirements to be a medical device in the Europe and North America.Conclusions The innovation holds promise in reducing upfront and life span costs for core equipment used in orthopaedic surgery without loss of effectiveness or safety benchmarks. However, the innovation needs to navigate complicated and decentralised procurement processes and clinicians and healthcare leaders need to overcome cognitive bias.


bhatti Y, taylor A, harris M, wadge H, escobar E, prime M, patel H, carter A, parston G, darzi Aet al., 2017, Global Lessons In Frugal Innovation To Improve Health Care Delivery In The United States, Health Affairs, Vol: 36, Pages: 1912-1919, ISSN: 0278-2715

In a 2015 global study of low-cost or frugal innovations, we identified five leading innovations that scaled successfully in their original contexts and that may provide insights for scaling such innovations in the United States. We describe common themes among these diverse innovations, critical factors for their translation to the United States to improve the efficiency and quality of health care, and lessons for the implementation and scaling of other innovations. We highlight promising trends in the United States that support adapting these innovations, including growing interest in moving care out of health care facilities and into community and home settings; the growth of alternative payment models and incentives to experiment with new approaches to population health and care delivery; and the increasing use of diverse health professionals, such as community health workers and advanced practice providers. Our findings should inspire policy makers and health care professionals and inform them about the potential for globally sourced frugal innovations to benefit US health care.


Bhatti Y, Prime M, Harris M, Wadge H, McQueen J, Patel H, Carter A, Parston G, Darzi Aet al., 2017, The search for the Holy Grail -- frugal innovation in healthcare from developing countries for reverse innovation to developed countries, BMJ Innovations, Vol: 3, Pages: 212-220, ISSN: 2055-642X

The healthcare sector stands to benefit most from frugal innovation, the idea that more can be done for less for many more people, globally. As a first step for health systems to leverage new approaches to offset escalating health expenditures and to improve health outcomes, the most relevant frugal innovations have to be found. The Institute of Global Health Innovation was commissioned by the US-based Commonwealth Fund to identify frugal innovations from around the world that could, if transferred to the USA, offer approaches for expanding access to care and dramatically lower costs. Our global scan was motivated by the need to extend the list of frugal innovations in healthcare beyond the impressive but oft-repeated examples such as GE’s MAC 400, a US$800 portable ECG machine, Narayana’s US$1500 cardiac surgery and Aravind’s US$30 cataract surgery. Our search involved (1) scanning innovation databases, (2) refining frameworks to identify frugal innovations and evaluate their reverse potential and (3) developing in-depth case studies. From 520 possible innovations, we shortlisted 16 frugal innovations that we considered as frugal and with potential for reverse diffusion into high-income country health systems. Our global search was narrowed down to three care delivery models for case analysis: The Brazilian Family Health Strategy around community health workers; Singapore-based GeriCare@North use of telemedicine and Brazil’s Saude Crianca community involvement and citizenship programme. We share core features of the three frugal innovations and outline lessons for practitioners, scholars and policymakers seeking to lower healthcare costs while increasing access and quality.


Harris MJ, Marti J, Watt H, Bhatti Y, Macinko J, Darzi Aet al., 2017, Explicit Bias Toward High-Income Country Research: A Randomized, Blinded, Crossover Experiment Of English Clinicians, Health Affairs, Vol: 36, Pages: 1997-2004, ISSN: 0278-2715

Unconscious bias may interfere with the interpretation of research from some settings, particularly from lower-income countries. Most studies of this phenomenon have relied on indirect outcomes such as article citation counts and publication rates; few have addressed or proven the effect of unconscious bias in evidence interpretation. In this randomized, blinded crossover experiment in a sample of 347 English clinicians, we demonstrate that changing the source of a research abstract from a low- to a high-income country significantly improves how it is viewed, all else being equal. Using fixed-effects models, we measured differences in ratings for strength of evidence, relevance, and likelihood of referral to a peer. Having a high-income-country source had a significant overall impact on respondents’ ratings of relevance and recommendation to a peer. Unconscious bias can have far-reaching implications for the diffusion of knowledge and innovations from low-income countries.


Kulasabanathan K, Issa H, Bhatti Y, Prime M, del Castillo J, Darzi A, Harris Met al., 2017, Do international health partnerships contribute to reverse innovation? A mixed methods study of THET-supported partnerships in the UK, Globalization and Health, Vol: 13, ISSN: 1744-8603

BackgroundInternational health partnerships (IHPs) are changing, with an increased emphasis on mutual accountability and joint agenda setting for both the high- and the low- or middle-income country (LMIC) partners. There is now an important focus on the bi-directionality of learning however for the UK partners, this typically focuses on learning at the individual level, through personal and professional development. We sought to evaluate whether this learning also takes the shape of ‘Reverse Innovation’ –when an idea conceived in a low-income country is subsequently adopted in a higher-income country.MethodsThis mixed methods study used an initial scoping survey of all the UK-leads of the Tropical Health Education Trust (THET)-supported International Health Partnerships (n = 114) to ascertain the extent to which the IHPs are or have been vehicles for Reverse Innovation. The survey formed the sampling frame for further deep-dive interviews to focus on volunteers’ experiences and attitudes to learning from LMICs. Interviews of IHP leads (n = 12) were audio-recorded and transcribed verbatim. Survey data was analysed descriptively. Interview transcripts were coded thematically, using an inductive approach.ResultsSurvey response rate was 27% (n = 34). The majority (70%) strongly agreed that supporting LMIC partners best described the mission of the partnership but only 13% of respondents strongly agreed that learning about new innovations and models was a primary mission of their partnership. Although more than half of respondents reported having observed innovative practice in the LMIC, only one IHP respondent indicated that this has led to Reverse Innovation. Interviews with a sample of survey respondents revealed themes primarily around how learning is conceptualised, but also a central power imbalance between the UK and LMIC partners. Paternalistic notions of knowledge could be traced to partnership p


Harris MJ, Bhatti Y, Prime M, del Castillo J, Parston G, Darzi Aet al., 2016, Global Diffusion of Healthcare Innovation: Making the Connections. Report for the World Innovation Summit for Health, World Innovation Summit for Health 2016, Publisher: World Innovation Summit for Health

04GDHIEXECUTIVE SUMMARYThis research is part of the ongoing study of GDHI. The diffusion or spread of innova-tions over time through a specific population or social system is important to unlock the potential benefits of an innovation. There has been much study of how to encour-age the uptake of innovations so that they become part of everyday practice and ben-efit many, rather than a few. In this research, we explore this from the demand side. We explore how FHWs and leaders find solutions to their everyday challenges, and which sources are the most influential. We consider how these groups are sourcing solutions to their problems in six countries and how healthcare organizations can source innovations more effectively to meet the needs of FHWs and leaders. The study also explores the role that ‘curator organizations’ – a specialized set of organ-izations that source innovations from around the world – are playing in helping to diffuse innovations into clinical practice. We consider what role these organizations could play in future to ensure that they are relevant to frontline needs. The study builds on previous findings from 2013 GDHI research that showed how cer-tain system characteristics, enablers and frontline behaviors are critical to diffusion.1It follows on from the 2015 GDHI study that assessed the importance and prevalence of these elements in eight case studies of rapid, successfully scaled innovations.2This year, our study focuses on how FHWs and organization leaders source innova-tion in the first place. Our research draws on quantitative surveys of more than 1,350 FHWs in major urban centers of six countries (England, the United States (US), Qatar, Brazil, India and Tanzania). We conducted more than 90 personal interviews with healthcare leaders in these locations and in-depth conversations with the managers of 10 curator organizations.


Harris MJ, Bhatti Y, Prime M, del Castillo J, Parston G, Darzi Aet al., 2016, Global Diffusion of Healthcare Innovation: Making the Connections, Global Diffusion of Healthcare Innovation: Making the Connections, Publisher: Qatar Foundation


Attaelmanan I, Bhatti YA, Harris M, Prime M, Darzi Aet al., The development and diffusion of surgical frugal innovations – lessons for the NHS, LSE International Health Policy Conference 2017


Prime M, Bhatti Y, Harris M, 2016, Frugal and Reverse Innovations in Surgery, Global Surgery: The Essentials, Editors: Park, Price


Prime M, Bhatti Y, Harris M, African healthcare innovation: an untapped resource?, World Hospitals and Health Services Journal


Harris M, Bhatti Y, Darzi A, 2016, Does the Country of Origin Matter in Health Care Innovation Diffusion?, Journal of the American Medical Association, Vol: 315, Pages: 1103-1104, ISSN: 0002-9955


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