Hello there, Jeaneth Johansson and Ulrik Röijezon—why aren’t digital innovations making their way all the way into healthcare?

Digital solutions are being developed, tested, and showing promising results. Yet many of them never make it into routine healthcare. Why does the journey end after the pilot project? Professors Jeaneth Johansson and Ulrik Röijezon at Luleå University of Technology (LTU) are investigating the barriers between innovation and actual use.

Jeaneth Johansson conducts research on innovation and entrepreneurship, while Ulrik Röijezon is a professor of physical therapy. Their perspectives converge in the INNOVAID research project. Ahead of the webinar on November 5, we asked them why promising solutions so often fall by the wayside—and what it takes for them to be adopted in healthcare.

You’re approaching the issue from two angles—physical therapy on the one hand, and innovation and entrepreneurship on the other. When did you realize that promising digital solutions weren’t making their way into mainstream healthcare?

Ulrik

– At LTU, I’ve set up a motion laboratory for objective motion analysis. The equipment is expensive and complex and is rarely used in healthcare. When the TV and video game industries began developing inexpensive and user-friendly sensors, such as the Wii, Kinect, and VR, I saw opportunities to use the technology in clinical settings.

– Even though our research and other studies show strong clinical evidence, these digital solutions are still not being used in healthcare. That baffles me, especially given the investments being made in e-health, community-based care, and precision health.

Jeaneth

– Many companies are developing solutions that could improve health care. Yet they are unable to make the leap from innovation to actual use and scaling up.

– Companies struggle for many years, and many also go bankrupt. At the same time, distances are great in Norrland, and it’s a long way to healthcare services. There are solutions that could help. This is where we want to make a difference. Through my work with our case study company, Curest, I’ve also gained a clearer picture of what’s needed and how we can help companies bridge this gap.

A digital product or service may work well in a pilot program—and yet never become part of routine care. Why is the step in between so difficult?

Jeaneth

– There are several reasons. Procurement laws are difficult to navigate, both for businesses and for the healthcare sector.

– When an innovation is introduced, it’s rarely enough to simply install new technology. Work processes and responsibilities often need to change at the same time. In an already strained organization, there’s not only a lack of money, but also a lack of time and energy to carry out that transition.

– Of course, the healthcare system can’t adopt every innovation out there. That would be overwhelming. We need innovation strategies and plans for how to implement new solutions, and those are often lacking today. At the same time, there are regions, such as Halland and the Västra Götaland Region, that are working very actively on these issues.

Ulrik

– Exactly. For digital solutions to be implemented, both practical support and the right conditions are needed. Innovative companies also have a responsibility: they must demonstrate the benefits their solutions provide and educate both prospective and existing customers, especially when the technology is perceived as complicated.

You describe a situation in which the person who sees the benefit is not always the one who pays or makes the decision. What are the consequences of this?

Jeaneth

– Different units and organizations are evaluated based on the economic benefits they generate themselves. This leads to a reluctance to pay for a solution if the benefits accrue elsewhere in the system. The result is that each unit optimizes its own finances, even when the healthcare system as a whole could benefit from the investment.

– For new solutions to be implemented, we therefore need new models of collaboration, but also new ways of measuring results. We need to view value in a broader context, not just within a single unit or organization.

Digital solutions can be particularly valuable in areas where distances are great and resources are limited. What difference can they make in sparsely populated and rural areas?

Ulrik

– Long distances and a lack of specialized expertise characterize large parts of northern Sweden, not least Norrbotten. Digital solutions are crucial if the healthcare system is to meet current and future needs for accessibility, quality, and equity—regardless of where people live.

– But the technology must address a real need and be supported by clinical evidence. It also needs to deliver better results or lower costs than current alternatives. Finally, procurement and reimbursement systems must make its adoption possible.

– One challenge we’ve seen is that the cost of a solution may fall on one party, while the savings go to another. That’s why someone needs to take overall responsibility for the entire process.

Jeaneth

– We also need good examples that show how this can work in practice and how it can be implemented. Organizations such as the Center for Health in Rural Areas can help lead the way here.

Procurement and reimbursement systems are often described as obstacles. How could they, instead, help more innovations be adopted in healthcare?

Jeaneth

– Both the regions and businesses need a better understanding of how to procure health innovations. That way, they can make use of the flexibility already provided by current legislation.

– Today’s reimbursement systems are also not adapted to digital healthcare. They are still largely designed for—and prioritize—in-person care. They need to be developed and adapted.

When publicly funded healthcare does not purchase new products and services, smaller medical technology companies can turn to private healthcare providers, insurance companies, or patients. What opportunities and risks does this create?

Ulrik

– This could lead to more unequal access to healthcare, where only people who can pay out of pocket or have private insurance have access to these solutions.

– At the same time, there is a risk that publicly funded healthcare will fall behind in terms of both technological solutions and expertise.

Jeaneth

– At the same time, these alternative approaches can make it possible to implement, test, and scale up health innovations more quickly. Private healthcare providers and insurance companies can contribute resources and serve as key partners.

– There is no single path to ensuring that innovations benefit patients. However, these developments must be combined with active efforts to ensure equal access to care.

On November 5, Esbri and the INNOVAID research project will host the webinar “The Innovations Exist—How Do We Get Them All the Way into Healthcare?” The project is led by Professors Jeaneth Johansson and Ulrik Röijezon. Learn more and register for the webinar.

About the
ProjectIn the INNOVAID research project—Innovation Procurement to Accelerate Digital Health Implementation—Professors Ulrik Röijezon and Jeaneth Johansson, both at Luleå University of Technology, are investigating how digital health innovations can move from testing and evidence-based evaluation to procurement and routine use.

The project focuses on small and medium-sized enterprises and the conditions in northern Sweden, and is funded by Norrlandsnavet and PRECISE. Norrlandsnavet at Luleå University of Technology is, in turn, funded by the Kamprad Family Foundation.