The organization I represent, ACCESS Health, has been associated with an initiative called the Center for Health Market Innovations (CHMI). It is an interesting compendium of healthcare models across the world that many deem innovative (albeit there are no set inclusion/ exclusion criteria). The initiative provides profiles of about 1,135 innovative models with interesting data if one is interested in investigating any trends (Link here; look for the “Download database” link). The innovations are categorized into five buckets – Organizing Delivery; Financing Care; Regulating Performance; Changing Behaviors; Enhancing Processes. I have had considerable involvement with this initiative at ACCESS Health and below are my thoughts on models that others believe are innovative.
This is how I would define innovation in this context: any model that can decrease the cost of conventional service delivery (significantly or marginally) or increase the access to care (both physical reach and financially) or both.
Based on my experience, I believe that any healthcare service delivery innovation can be safely classified into the below three vectors or a combination thereof:
1. Cheaper Supplies: This is obviously a no-brainer. No points for guessing! Supplies here primarily mean medicines but also include equipment. Usage of generic medicines, efficiently estimating and forecasting their demand, optimum procurement, scientific inventory management and distribution and last but not the least influencing patient behavior to promote the use of generic medicines. Here is a classic example of a model doing just this (Link Here)
2. Cross-subsidisation: Using the user-fees generated from a relatively affluent patient population to finance care for the not-so-affluent patient population. While there are straight forward models that utilize this method, like LVPEI or SEVA, a few models that use some form of social/ community insurance to finance care also fall under this category. In the latter case, cross-subsidization is achieved through risk pooling (assuming, no adverse selection).
3. Task Shifting: Training un-skilled/ semi-skilled people to perform tasks that would have otherwise been carried out by people who are more expensive to deploy. For example, using nurses to carry out preliminary screening instead of doctors or using people who have at least 10 years of formal education to perform paramedical duties. This is the most common method used to reduce cost and increase patient turnover. (Check here and here)
Thoughts anyone?
Of This & That 