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COVID-19 has widened the chasm of institutional voids already existing within the Indian society. Although institutional voids are impediments to effective transactions and the spread of beneficial services (such as reliable healthcare), they are also opportunities for entrepreneurial and innovative interventions. Entrepreneurship as the economist Joseph Schumpeter described is a process of ‘creative destruction’ by pushing through and successful introduction of a new product, method of production, market, organization or combination of already existing means through innovation for solving meaningful problems and value creation. 

Healthcare entrepreneurship and innovation responds to unmet public health needs by creating new ways of thinking and working with a focus on the needs of populations.

Health innovation as defined by the World Health Organization (WHO) is to develop and deliver new or improved health policies, systems, products and technologies, and services and delivery methods that improve people’s health and wellbeing. Healthcare entrepreneurship and innovation responds to unmet public health needs by creating new ways of thinking and working with a focus on the needs of populations. It aims to address these voids and add value in the form of improved efficiency, effectiveness, quality, sustainability, safety and affordability.

The healthcare sector is transforming by digital bytes, novel organisms and personalized genetic interventions.

With the COVID-19 pandemic hitting India hard especially in economic hotspots like Mumbai, and healthcare system struggling to cope, innovation and entrepreneurship could be the potential vital bridge to fill the gap in the healthcare system. Healthcare startups which are a reflection of the Indian healthcare innovation sector is the second largest startup sector in India and shown a high growth rate in recent years, and India has emerged as the third largest startup economy in the world. With favorable government policies, innovators in healthcare sector have identified ways to deliver effective healthcare at significantly lower cost, while improving access and increasing quality and contributing to the growth of healthcare sector. COVID-19 provides a unique opportunity to leverage this start up sector to address the current situation in India as well as for the future.

With social distancing norms and movement restricting protocols, direct face to face consultations between doctors and patients are going to be events of the past. Disruptive technologies driven by technology platforms linking doctors and patients, low cost medical devices, technology-enabled diagnostics, artificial intelligence and telemedicine will become the norm rather than exception in the future and will shape the future of healthcare in India. The potential and reach of technology is enormous and if tapped constructively and effectively could reach out to remote corners of India, plagued by shortages of healthcare work force. 

The SMART framework for HTA development is a useful tool in this context especially for low and low-middle income countries like India.

Unfortunately, healthcare can be a sectorally compartmentalized and local activity resulting in innovations which are not widely known across different systems or beyond sector boundaries. Hence, just identifying and promoting innovations isn’t enough, but it is important to understand whether, and how, these innovations are addressing health system challenges of access, equity and quality. In this context the role of Health Technology Assessment (HTA) for understanding the value of health innovations becomes important to inform policy decisions.While, HTA has become an established multi-disciplinary tool in the developed countries with well-established systems in place, its adoption in low-middle income countries like India needs to be contextualized. The SMART framework for HTA development is a useful tool in this context especially for low and low-middle income countries like India. The first HTA from South Asia on a COVID-19 diagnostic medical device was conducted on the innovative FELUDA diagnostic test, which showed the value of this innovation in terms of efficiency, equity, and sustainability of healthcare systems.

As health systems leaders and policy makers worry on their cost, quality, and access problems, the fact remains that at least some potential solutions already exist. Innovators around the globe including India have demonstrated effective ways to improve quality and lower costs through novel ways of preventive, promotive, curative, rehabilitative and/or assistive care. The real challenge lies in implementing in local settings and subsequent scaling up. 

While epidemiologists and economists create models to try to predict the future of COVID-19, perhaps it is an opportune time for leaders to become ‘role models’ as ‘policy entrepreneurs’ and use effectuation principles and an opportunity based approach using episodic knowledge to make decisions for providing a coherent sustainable eco system for the large scale implementation of successful healthcare innovations. This would be a big step towards filling the chasm of institutional voids within healthcare. 

The healthcare sector is transforming by digital bytes, novel organisms and personalized genetic interventions. In such an environment, leadership in healthcare organizations requires entrepreneurial talent and healthcare organizations need to transform their administrative focus by restructuring themselves into opportunistic and innovative firms that build trusting relationships with their stakeholders. With the number of cases and deaths due to COVID-19 rising every day, it has become the face of a ‘destructive creation’ of nature. However, COVID-19 also provides an opportunity for application of innovation and entrepreneurship in healthcare to creatively destroy inefficiencies, inequity, poor quality and become a transformative tool for ‘creative destruction’.

Composed by: “Dr Kanchan Mukherjee is a medical doctor who specializes in public health, health policies and systems, economic evaluations, Health Technology Assessment (HTA) and health innovation research. He is professor at the Centre for Health Policy, Planning and Management at the Tata Institute of Social Sciences, Mumbai.”

InnoHEALTH magazine digital team

Author InnoHEALTH magazine digital team

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