A model for ‘reverse innovation’ in health care

Abstract

‘Reverse innovation,’ a principle well established in the business world, describes the flow of ideas from emerging to more developed economies. There is strong and growing interest in applying this concept to health care, yet there is currently no framework for describing the stages of reverse innovation or identifying opportunities to accelerate the development process. This paper combines the business concept of reverse innovation with diffusion of innovation theory to propose a model for reverse innovation as a way to innovate in health care. Our model includes the following steps: (1) identifying a problem common to lower- and higher-income countries; (2) innovation and spread in the low-income country (LIC); (3) crossover to the higher-income country (HIC); and (4) innovation and spread in the HIC. The crucial populations in this pathway, drawing from diffusion of innovation theory, are LIC innovators, LIC early adopters, and HIC innovators. We illustrate the model with three examples of current reverse innovations. We then propose four sets of specific actions that forward-looking policymakers, entrepreneurs, health system leaders, and researchers may take to accelerate the movement of promising solutions through the reverse innovation pipeline: (1) identify high-priority problems shared by HICs and LICs; (2) create slack for change, especially for LIC innovators, LIC early adopters, and HIC innovators; (3) create spannable social distances between LIC early adopters and HIC innovators; and (4) measure reverse innovation activity globally.

Community Health Workers as Innovators: Methods and Results from a Tele-Education Pilot for Community Health Workers in Detroit, Michigan

“…Rogers' Diffusion of Innovation theory describes five sections of adopters throughout society: innovators, early adopters, early majority, late majority, and laggards. In Depasse and Lee's model for reverse innovation in health care settings [21], they utilize these adopter categories to explain the spread of innovations from low-income areas to high-income areas. Across settings, when the early adopters in a low-income area accept an innovation, the innovators in a high-income area tend to start adoption and the innovation moves throughout the five adopter categories according to the five factors of the Diffusion of Innovation theory.…”

“…In their model applying reverse innovation to the health care sector, DePasse and Lee practically define reverse innovation as "learning from and investing in poorer settings as one way to tackle problems in wealthier settings that require out-ofthe-box solutions" [21]. With rising healthcare costs and increasingly complex, multi-determinant health challenges, the need for creativity and innovative thinking has never been higher.…”

“…DePasse and Lee also utilize the Diffusion of Innovation theory in their model of reverse innovation in health care [21], which will be discussed further in reference to the pilot study results. CHWs, because of their close contact to the thought-leaders of their communities, are perfectly situated to know and create options that are superior to current approaches that fail to satisfy the needs of their neighbors.…”

Thinking globally, training locally

“…12 ''Reverse innovation'', describing the flow of ideas from emerging to developed economies, is well established in the business community and is gaining increasing traction in healthcare. 13 There are opportunities for collaborative academic and research pursuits. Collaboration brings unparalleled educational experiences for both trainees and staff, particularly in the intrinsic CanMEDs roles, such as health advocacy, collaboration, and leadership, 14 which can be underemphasized in training at home.…”

Medical Device Innovation in the Era of the Affordable Care Act: The End of Sexy

“…It can be used without specialized training and costs a fraction of the $4,000 systems used in industrialized countries (Löscher, 2011). Crucially, such innovations, while originally conceived for developing markets, can eventually become "good enough" to displace the established and costly technologies that are in use in the developed world, a process called reverse innovation (DePasse and Lee, 2013). area (Figure 2), appears expensive, with a list price of $96, but can prevent the occurrence of high-cost pressure ulcers (Santamaria et al, 2015).…”