33 results found
Brown C, Bhatti Y, Harris M, 2023, Environmental sustainability in healthcare systems: role of frugal innovation, BMJ, Vol: 383, ISSN: 1759-2151
Abdulaziz AA, Algosaibi AM, Alquhaibi AS, et al., 2023, Digital Healthcare Innovation and Development in Saudi Arabia During and Beyond COVID-19, Science, Technology and Society, Vol: 28, Pages: 370-386, ISSN: 0971-7218
COVID-19 forced many nations, including the largest country in the Arabian Gulf region, Saudi Arabia, to fast-track the adoption of new technologies and work practices to cope with the pandemic. We find the Saudi Ministry of Health (SMoH), in less than a year, introduced several innovations to transform healthcare planning, management and delivery. We reflect on these changes in the Saudi Arabian context and suggest what needs to be done next to retain the developmental momentum generated in the innovation system beyond the pandemic for sustainable and positive impact on the healthcare system. To do so, the Ministry should regularly assess the appetite for change, prioritise problems and areas of intervention, collect evidence of need and impact, build confidence by educating the public and healthcare professionals about the importance of adapting to new ways and methods of healthcare delivery, collaborate with the private sector to efficiently sustain these advancements and gain the public’s trust through stakeholder participation.
Bhatti Y, Ramirez R, Athanasopoulou A, 2023, The value produced in lending strategic problems as live cases in futures education, FUTURES, Vol: 148, ISSN: 0016-3287
Dominguez MFO, Bhatti YA, 2022, From waste to luxury fashion at Elvis & Kresse: a business model for sustainable and social innovation in the circular economy, Sustainability, Vol: 14, Pages: 1-17, ISSN: 2071-1050
Managing landfill waste is essential to sustainable resource utilization. With a focus on the luxury fashion industry, this paper highlights the role that sustainable and social innovations can play in reducing environmental waste and improving social outcomes. Elvis & Kresse is a purpose-driven case study, because it was founded to eradicate a problem that had thus far received little attention, namely the problem of disposing of end-of-life fire-hoses. From a business model and circular economy perspective, this article explains how the company’s rescue–transform–donate model has helped to build a sustainable and socially oriented yet profitable luxury brand. The analysis of the case suggests that for scholars, the typical business model canvas merits some revision beyond the current business focus on the financial bottom line to account for the social and ethical dimensions. For practitioners, this case demonstrates how the circular economy can be compatible with luxury fashion by turning waste into durable, fashionable products.
Hossain M, Agarwal N, Bhatti Y, et al., 2022, Frugal innovation: Antecedents, mediators, and consequences, CREATIVITY AND INNOVATION MANAGEMENT, Vol: 31, Pages: 521-540, ISSN: 0963-1690
Selhorst S, OToole RV, Slobogean GP, et al., 2021, Is a low-cost drill cover system non-inferior to conventional surgical drills for skeletal traction pin placement?, Journal of Orthopaedic Trauma, Vol: 35, Pages: e433-e436, ISSN: 0890-5339
The Drill Cover system was developed as a low-cost alternative to conventional surgical drills with specific applicability to low- and middle-income countries. However, the system may also be useful for the sterile placement of traction pins in the emergency department of high-income country hospitals. In September 2019, a US-based Level-1 trauma center began using the Drill Cover system to apply skeletal traction pins in patients with femoral shaft fractures. With these data, we performed a retrospective interrupted time series study to determine if the Drill Cover system was non-inferior to conventional surgical drills in terms of infections at the traction pin site. The study included 205 adult patients with femoral shaft fractures initially placed in skeletal traction using a conventional surgical drill (n=150, pre-intervention group) or the Drill Cover system (n=55, post-intervention group). The primary outcome was an infection at the site of skeletal traction pin placement that required surgery or antibiotics was compared between groups using a non-inferiority test with a one-sided alpha of 0.05 and a non-inferiority margin of 3%. No infections at the site of skeletal traction pin placement were found in either the pre-intervention or the post-intervention group (difference 0%, 95% CI: 0.0 to 1.4%, non-inferiority p-value<0.01). The results suggest that the Drill Cover system was non-inferior to conventional surgical drills regarding infections at the site of skeletal traction pins. The Drill Cover system may be a safe alternative to the more expensive surgical drills for skeletal traction pin placement in the emergency room environment.
Skopec M, Grillo A, Kureshi A, et al., 2020, Double standards in healthcare innovations: the case of mosquito net mesh for hernia repair, BMJ Innovations, Vol: 7, Pages: 482-490, ISSN: 2055-642X
With over two decades of evidence available including from randomised clinical trials, we explore whether the use of low-cost mosquito net mesh for inguinal hernia repair, common practice only in low-income and middle-income countries, represents a double standard in surgical care. We explore the clinical evidence, biomechanical properties and sterilisation requirements for mosquito net mesh for hernia repair and discuss the rationale for its use routinely in all settings, including in high-income settings. Considering that mosquito net mesh is as effective and safe as commercial mesh, and also with features that more closely resemble normal abdominal wall tissue, there is a strong case for its use in all settings, not just low-income and middle-income countries. In the healthcare sector specifically, either innovations should be acceptable for all contexts, or none at all. If such a double standard exists and worse, persists, it raises serious questions about the ethics of promoting healthcare innovations in some but not all contexts in terms of risks to health outcomes, equitable access, and barriers to learning.
Javed M, Bhatti Y, 2020, Frugal solutions., Br Dent J, Vol: 229
Harris M, Bhatti Y, Prabhu J, 2020, Frugal Innovation for Today’s and Tomorrow’s Crises, Stanford Social Sciences Review
Harris M, Bhatti Y, Buckley J, et al., 2020, Fast and frugal innovations in response to COVID19 pandemic, Nature Medicine, Vol: 26, Pages: 814-817, ISSN: 1078-8956
Necessity has been the mother of invention in the response to the COVID-19 pandemic, triggering many an innovation, often without the luxury of time to test these makeshift solutions to pressing problems. But there is much to be learned from times of crisis for times of plenty.
Ramirez R, Bhatti Y, Tapinos E, 2020, Exploring how experience and learning curves decrease the time invested in scenario planning interventions, TECHNOLOGICAL FORECASTING AND SOCIAL CHANGE, Vol: 151, ISSN: 0040-1625
Bhatti Y, Prabhu J, 2019, Frugal innovation and social innovation: linked paths to achieving inclusion sustainably, Handbook of Inclusive Innovation: The Role of Organizations, Markets and Communities in Social Innovation, Pages: 354-376, ISBN: 9781786436009
Amidst growing concern about inequality, there are calls for new ways to innovate to provide for more marginalized and underserved consumers globally. While individually the two concepts of social and frugal innovation have gained much prominence in practice and research, in this chapter the authors theoretically link the two to help increase our understanding of how to better achieve inclusive markets and societies both locally and globally. Social and frugal innovation independently seek to make the process and outcomes of innovation more economically and socially inclusive and sustainable, but together the sum of the two can be greater than the whole and can help us better tackle the problems that underpin Grand Challenges such as the Sustainable Development Goals. Accordingly, in this chapter, the authors discuss why social and frugal innovation are important together; where they find examples of such innovations; what the similarities and differences between the two are; and why a combined approach can solve the Grand Challenges of our time and improve social and economic inclusion sustainably around the world. The authors highlight opportunities for future research based on their model and discuss implications for research and practice. To outline key issues, they discuss substantive, conceptual and empirical concerns in linking frugal and social innovation through inclusion for both economic and social benefit. To capitalize on the potential intersection between social and frugal innovation, the authors invite researchers to advance theoretical and empirical studies and to practitioners and policy makers to harness hybrid models of innovation that can be instrumental in resolving the most pressing Grand Challenges globally.
Prime M, Attaelmanan I, Imbuldeniya A, et 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, Del Castillo J, Olson K, et al., 2018, Putting humans at the center of health care innovation, Publisher: Harvard Business Review
In light of growing discourse on 'frugal innovation', this book offers novel approaches to innovation based on extensive empirical research. The study complements a decade of scholarly attention on frugal innovation by taking a research-based approach to innovation in resource-scarce and complex institutional contexts. The findings suggest that concepts such as frugal, reverse, jugaad, social, grassroots and inclusive innovation in fact represent heterogeneous assemblies of innovation for social, environmental and economic value. The conceptual framework invites attention to more plural sources and elements in the study of models of innovation to inspire further research in the fields of strategy, innovation, entrepreneurship, economic sociology and development studies. The design framework offers models, metrics and competencies for practitioners and policymakers to identify, evaluate and design frugal innovations. The comprehensive view of frugal innovation demonstrates how firms can implement globally competitive strategies by pursuing innovation for humanity to improve lives for everyone, everywhere.
Prime M, Bhatti Y, Harris M, et al., 2017, Frugal innovations for healthcare: a toolkit for innovators, Academy of Management conference, Publisher: Academy of Management, ISSN: 2151-6561
Global health systems face significant challenges over the coming years to meet the increasing demands of ageing populations, the growing burden of chronic disease and the exponential cost of healthcare delivery. In response innovators from around the world are beginning to develop solutions that focus on reducing the cost of care; widen access to care; and challenge the dogma that more is better. So-called frugal innovations are defined as “means or ends, to do more with less, for the many” (Bhatti, 2014). This paper seeks to ask, “How can we identify frugal innovations for healthcare and how are they achieving frugality?” with the specific objective of developing a frugal innovation toolkit for healthcare. An emergent, embedded, mixed-methods research strategy was employed. A pilot study was used to develop the Frugal Innovation for Healthcare - Identification Tool (FIH-ID tool). A larger study was undertaken to identify a cohort of frugal innovations, evaluate the application of the FIH-ID tool, and assess the processes and strategies employed by frugal innovators. 56 semi-structured interviews were undertaken with 90 representatives of 28 healthcare innovations exhibiting at the World Innovation Summit for Health (WISH) 2015. 15 frugal innovations for healthcare were identified. Inter-observer agreement for application of the FIH-ID tool demonstrated a high proportion of agreement (Po = 0.714), and a “fair” Cohen’s Kappa score (K = 0.499). A thematic analysis identified key strategies applied by individuals or organizations to produce frugal innovations. These include: the application of new information & communication technologies; harnessing existing networks; simplification; changing the location of care; and task-shifting. This paper presents a toolkit of strategies for identifying and creating frugal innovations for healthcare. This research suggests that the FIH-ID tool is a reliable means of identifying exampl
Harris M, Bhatti Y, Prime M, et al., 2017, Low-cost innovation in healthcare: what you find depends on where you look, Journal of the Royal Society of Medicine, Vol: 111, Pages: 47-50, ISSN: 1758-1095
bhatti Y, taylor A, harris M, et 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, et 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, et 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, et 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, et al., 2016, Global Diffusion of Healthcare Innovation: Making the Connections, Global Diffusion of Healthcare Innovation: Making the Connections, Publisher: Qatar Foundation
Harris MJ, Bhatti Y, Prime M, et 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.
Attaelmanan I, Bhatti YA, Harris M, et al., 2016, 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, 2016, 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
Bhatti Y, Selin C, Ramirez R, et al., 2015, Introduction to the special issue in futures on design and scenarios, FUTURES, Vol: 74, Pages: 1-3, ISSN: 0016-3287
Bhatti YA, Ventresca M, 2013, How Can ‘Frugal Innovation’ Be Conceptualized?, SSRN Electronic Journal
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