Larry Arshoff is president and founder of Diagnosis, Solutions & Results Inc. (DS&R). He has over 30 years of experience in building and growing medical device and pharma businesses. Larry has over two decades executive and management experience including business unit leadership, business development, marketing, and sales positions at major multinational medical device and pharmaceutical corporations.

Larry’s past senior executive roles include positions at Alcon Canada, Bausch + Lomb Canada, and Novopharm Limited (now Teva Pharmaceuticals). Larry is a former board member of MEDEC and currently the Co-Chair (2013-2018) of the MEDEC Procurement Committee and the MEDEC chair of the In Vitro Diagnostics, Wound Care and Vision Care Committees. He holds Master of Science in Molecular Biology from McMaster University. He can be reached at: [email protected]

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Larry Arshoff

There are several challenges associated with introducing innovations into a healthcare institution. As the innovation becomes more disruptive, resistance to its adoption tends to rise. Thus, increasing the importance of an effective introduction, evaluation, and implementation plan. A major healthcare issue in Canada is related to the limited adoption of cost effective treatments (Drummond 2011). While benefits of value-based healthcare innovation are recognized as important, their adoption has challenges and often remains a time-consuming process. Companies launching an innovative product or service, need to accelerate its adoption into healthcare institutions to grow sales and market penetration.

We have observed that the issues faced by institutions in the healthcare sector are relatively similar regardless of the nature of the innovation (including processes, medical devices, and pharmaceuticals). There are several initiatives under consideration or initiated by provincial governments to help accelerate innovation adoption especially when it relates to better patient outcomes, sustainability, and/or value-based healthcare.

Recognizing the challenges and the need for an effective means to adopt innovation, we have worked with several technologies and institutions and developed a unique approach to help accelerate the adoption of medical innovations.

Factors that delay innovation adoption

In addition to measuring the effectiveness of treatments in terms of patient and quality outcomes, health technology assessments also consider societal and systemic economic data needed to support value-based healthcare transformation. It is noteworthy that while many innovations can receive a positive health technology assessment, their adoption is not always assured.

There are several attributes that are specifically related to use and utility that affect the adoption of any medical innovation, several are listed in the table below (Ghodeswar and Vaidyanatha 2006). In contrast, it is also useful to compare attributes to reasons why people resist change. In contrast, it is also useful to compare attributes to reasons why people resist change (Moss-Kanter 2012).

There needs to be a balance between meeting the attribute criteria and addressing the reasons for resisting change. This helps accelerate the adoption of innovation. As well, it Is important to recognize that despite the challenges with innovation adoption and wanting a rapid implementation process, there is a degree of inertia that is built into decision-making and implementation processes that helps safeguard against rash decisions. And if it is not managed effectively, it can become a barrier to innovation adoption (Arshoff 2010).

What can be done to help accelerate innovation adoption?

Based on research and our experience, we developed an approach that supports and can accelerate adoption of innovations. We have enhanced our earlier approach, which involved three steps: Educate, Review, and Reinforce (Lalla and Arshoff 2013). Our current model is a more encompassing approach that features four stages: Prepare, Engage, Plan and Proceed (or PEPP). The PEPP model is summarized below.

1. Prepare
The first stage is preparation. Effective preparation begins with starting the planning and introduction process early, with a focus on understanding the reasons for resisting adoption. This understanding often changes how innovation is introduced.

Identify and recruit champion(s) for the innovation’s adoption process. Our experience has shown that you may often need more than one champion at a site and the champions should be a mix of physicians and healthcare professionals
.
Both the clinical and economic data on outcomes should be defined and their benefits explained and aligned with hospital’s objectives, strategies, plans and quality improvement plans (QIP). As well, link outcomes to hospital metrics (e.g. savings due to reduced adverse events, shorter length of stay, and/or fewer readmissions).

Materials and plans that address issues and support hospital objectives and QIPs help build support for the innovation and its adoption.






2. Engage
Engagement of all individuals directly or indirectly who benefit from the innovation need to be identified. Being inclusive is important. Remember to include the obvious and non-obvious stakeholders as well as front line employees. A single voice that has not been engaged or included can slow (or stop) any implementation process.


Collect information about what is currently being done by interviewing all the identified stakeholders. Use the information to map the current process (including timelines). Identify strengths, weaknesses, challenges, and other areas that need improvement. Share information about innovation (including benefits rationale for its use as well as hospital objectives and plans) during interviews. Finally ask interviewees where they think the innovation fits relative to their responsibilities, patient care challenges and hospital plans.
It is also important to ask them what they consider to be challenges associated with adopting this innovation.

3. Plan
Consolidate findings and information to develop a map of current processes showing strengths, weaknesses, timelines, and any learnings. Develop a strawman proposed implementation adoption plan.

Conducting an implementation/adoption workshop is a key step to gain support for the innovation. The workshop allows stakeholders to collectively review, analyze and enhance the strawman proposed plan. After the meeting and based on learnings and suggestions, amalgamate the findings into a single document adoption/implementation plan.

4. Proceed
After the plan is completed and there is engagement with enough buy-in from stakeholders, the next step would be the launch of implementation plan.

Conduct launch meeting(s) with all stakeholders and employees who could be directly or indirectly affected by the adoption of the innovation. Remind attendees of the inclusive processes such as the engagement and participation levels. Share implementation plan, timelines and launch date.

As the plan gets implemented, it is crucial that the progress be monitored and issues/challenges be addressed as priority. Employees tend to quickly identify challenges and nimble adjustments to the plan are critical to ensure engagement, support, and a successful adoption.

Lastly, schedule and conduct status updates. Initially, the updates should be daily, then moved to weekly, monthly, biannually and annually routine. The objective of the updates is to course correct and optimize. Organizations that plan to introduce innovation should allocate sufficient time and resources to successfully adopt innovation.

Following the PEPP model can help accelerate adoption of innovation. Since you are helping to solve hospital issues and address their plans, this approach should also increase your leverage with the key stakeholders at the hospital.

References

– Arshoff, Larry. 2010. Assesing innovations: What is the optimal approach for healthcare organizations? HealthCare Quarterly, Voll 13 No 2 pp 87-89

– Drummond, D. 2011. Therapy or Surgery? A Prescription for Canada’s Health System, Benefactors Lecture. Toronto: C.D. Howe Institute

– Ghodeswar, and Vaidyanatha. 2006. Adoption of medical technology by hospitals a review of innovation attributes and a conceptual model of the resulting service. World Review of Science, Technology and Sustainable Development, Vol. 3, No. 4 pp 362-380

– Lalla, F, and L Arshoff. 2013. “A mental health initiative to enahnce schizophrenia treatment efficcy.” Healthcare Managment Forum (Healthcare Managment Forum vol 26, pp 46-50) 26:46-50

– Moss-Kanter, R. 2012. Ten Reasons People Changes. Harvard Bsuiness Review https://hbr.org/2012/09/ten-reasons-people-resist-chang#comment-section