Background
Methods
Literature review and initial criteria development
Primary testing on case studies of innovative programs
Secondary testing with expanded sample of programs
Expert consultation in modified Delphi process
Results
Case examples
Brief description of initiative: An information network for community health workers using low-cost PDAs and cellular networks to collect and share critical health data
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Step 1
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Criteria
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Description
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Score
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Rationale
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1. Accessibility | Innovation increases access of products or services through increasing affordability, geographic access, and/or social access. | 4 | The program provides community health workers with PDAs that automatically load public health data to a centralized data bank. This helps with disease surveillance to ensure the right medicines and services are directed where needed. |
2. Cost Effectiveness | Innovation improves cost effectiveness to payer, provider, or end user. | 5 | A study by independent consultants reported a savings of 25% per unit compared to traditional manual paper data collection. |
3. Scalability | Innovation increases scope, geographic cover, or customer base. | 4 | There are 700 health workers in the program. There are 175 remote health facilities in the country that now have PDA capability, serving 1.5 million people. |
4. Effectiveness | Documentation of effectiveness of innovation using appropriate evaluative methods | 3 | The cost-effectiveness of the program has been evaluated by independent consultants. The program is currently evaluating its health impact on healthcare planning, resource allocation, and delivery. |
TOTAL SCORE | 16 | Conclusion: Move to Step 2 | |
Step 2
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Criteria
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Description
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Score
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Rationale
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5. Gap in Target HIC | Creating solutions for unsolved (or imperfectly solved) challenges or unaddressed health issues or service gaps. | 5 | Information integration and digitalization, with particular attention to cost control, are extremely important challenges for the Canadian health system. |
6. Compatibility | Compatible with healthcare infrastructure in the target HIC. | 3 | It is unclear how this information system would be regulated in the Canadian context, particularly with privacy considerations. However, the system could likely be adapted to meet Canadian regulations. |
7. Novelty | The innovation is a novel approach or an established innovation used in a new way that has great promise. | 4 | PDAs and smartphones remain a relatively innovative, uncommon tool for health data collection in Canada. |
8. Receptivity | Openness and engagement of partners as well as those not considered partners but who may be impacted by the innovation. | 4 | The IDRC and former CIDA are the primary funders of this initiative, suggesting strong connections to Canada. |
TOTAL SCORE | 16 | Conclusion: Score is ≥16. Likely to be a reverse innovation. |
Brief description: The program trains assistant medical officers and midwives in remote areas to perform life-saving procedures including caesarean sections and upgrades isolated health centers
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Step 1
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Criteria
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Description
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Score
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Rationale
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1. Accessibility | Innovation increases access of products or services through increasing affordability, geographic access, and/or social access. | 5 | The program has upgraded 9 remote health centers, increasing geographic access to services provided locally; prior to the program, patients had to travel 3-4 hours to the nearest hospital. |
2. Cost Effectiveness | Innovation improves cost effectiveness to payer, provider, or end user. | 4 | Indirectly, the program has improved cost effectiveness by "up-training" midwives to perform more complex tasks such as c-sections, reducing the need for more costly healthcare providers. |
3. Scalability | Innovation increases scope, geographic cover, or customer base. | 4 | Since inception, the program has increased its coverage from 9 sites to 12, and has been expanding to e-Learning platforms in 2013. Deliveries at all intervention hospitals have increased from 3,500 deliveries per year before the program to 9,000 deliveries per year after the program launch. |
4. Effectiveness | Documentation of effectiveness of innovation using appropriate evaluative methods. | 3 | One district where the program operates experienced a 32% decline in maternal deaths after the program was implemented. However, information on evalulation techniques and reporting on impact for all sites is limited. |
TOTAL SCORE | 16 | Conclusion: Move to Step 2 | |
Step 2
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Criteria
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Description
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Score
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Rationale
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5. Gap in Target HIC | Creating solutions for unsolved (or imperfectly solved) challenges or unaddressed health issues or service gaps. | 4 | Access to quality maternity care services, particularly in rural and northern areas, is an important healthcare issue in Canada. |
6. Compatibility | Compatible with healthcare infrastructure in the target HIC. | 1 | Midwives and physician assistants play a limited role in Canada as of present. Implementation of such a program would challenging given current regulations and staffing levels. |
7. Novelty | The innovation is a novel approach or an established innovation used in a new way that has great promise. | 3 | Midwifery and physician-assistant - performed c-sections are quite a novel concept; however refurbishing rural hospitals is not. |
8. Receptivity | Openness and engagement of partners as well as those not considered partners but who may be impacted by the innovation. | 1 | This initiative does not involve Canadian partners or Canadian stakeholders. |
TOTAL SCORE | 9 | Conclusion: Score is ≤10. Unlikely to be a reverse innovation. |