The COVID-19 Crisis Has Sparked Innovation and Offers Lessons We Must Not Forget

 In Land, Industry, Acquisition, & Innovation, UK, Forces & Capabilities

COVID-19 has shocked the world and caught most coun­tries unpre­pared, forc­ing them to impro­vise how best to pro­tect the health of their pop­u­la­tions. Among all the poten­tial con­se­quences now being faced, the health risks are undoubt­ed­ly the most alarm­ing. The wider social and eco­nom­ic con­se­quences are also start­ing to hit home, but have yet to fully unrav­el. However, amid all the con­fu­sion and the fear, the power of indi­vid­u­als, organ­i­sa­tions, and com­mu­ni­ties to think dif­fer­ent­ly and to inno­vate shows what can be achieved when people are united by common, clear pri­or­i­ties and neces­si­ty.

Earlier this year, RAND Europe pub­lished the results of many years of research focused on innovation in the healthcare system. We flagged that a lack of fund­ing is not the only (and per­haps not even the biggest) bar­ri­er to med­i­cines, med­ical devices, diag­nos­tics, and inno­v­a­tive meth­ods reach­ing those in need, on time and at scale. Our rec­om­men­da­tions con­sid­ered how to build inno­va­tion skills and train the health­care work­force and entre­pre­neurs, and how to strength­en lead­er­ship, incen­tives, and account­abil­i­ties to help the adop­tion of inno­va­tion in the NHS.

Our research also out­lined actions to sup­port better coor­di­nat­ed col­lab­o­ra­tion between dif­fer­ent research and inno­va­tion ini­tia­tives, fun­ders, and pol­i­cy­mak­ing bodies, and steps to ensure that patients and the public can effec­tive­ly con­tribute to progress and ben­e­fit from it. Our assump­tion was that many of the rec­om­men­da­tions we put forth will take months at best, and years more likely, to be put into prac­tice — because the trans­la­tion of research and inno­va­tion into prac­tice gen­er­al­ly takes a lot of time to unfold.

But if there is one thing that the response to COVID-19 is demon­strat­ing, it is that when there is a crit­i­cal mass of will and clear pri­or­i­ties, inno­va­tion can quick­ly reach the front line — to save lives and pro­tect the health and well-being of health­care work­ers, patients, and the public. People can be trained up, skilled, and re-skilled at pace. Political will and clear lines of account­abil­i­ty can shift courses of national action rapidly, in response to a rapid­ly evolv­ing evi­dence base.

When there is a crit­i­cal mass of will and clear pri­or­i­ties, inno­va­tion can quick­ly reach the front line.

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Innovation is coming togeth­er in the most inspir­ing of ways. Researchers are work­ing close­ly with pol­i­cy­mak­ers and those at the NHS front line to roll out inno­va­tions that would in other cir­cum­stances take years to bring to patients. Digitally-enabled con­sul­ta­tions (e.g., video con­sul­ta­tions, online con­sul­ta­tions) are now becom­ing rou­tine prac­tice for deal­ing with patients overnight in both acute and primary care in the NHS (wher­ev­er pos­si­ble). And guidance on how to do them well has been pro­duced in response to the degree of need and urgency that COVID-19 presents. The best avail­able evi­dence on issues such as diagnosing breathlessness is being translated into testing regimes in a matter of hours and days (PDF).

This fast pace of trans­la­tion comes with its own risks and trade-offs, for exam­ple, data secu­ri­ty risks or per­pet­u­at­ing inequal­i­ties in access to care for those who are not dig­i­tal­ly con­nect­ed. But all those involved are work­ing hard to learn quick­ly about how to lever­age the power of dig­i­tal com­mu­ni­ca­tions, while man­ag­ing the risks and ensur­ing prac­tices have indi­vid­ual con­sent behind them.

The research com­mu­ni­ty is also turn­ing around stud­ies and pub­lish­ing evi­dence at an unprece­dent­ed pace. For exam­ple, Oxford University has estab­lished a COVID-19 Evidence Service which pub­lish­es reg­u­lar reports on ques­tions that NHS staff at the front line and pol­i­cy­mak­ers urgent­ly need answers to.

Industry actions are rem­i­nis­cent of what hap­pened in response to the emer­gence of HIV, when large pharma com­pa­nies donat­ed com­pounds for test­ing to accel­er­ate anti­retro­vi­ral research and devel­op­ment. Compounds are being donated, tested, and entering trials quickly. For exam­ple, the UK has just begun a trial of a com­bi­na­tion of com­pounds used to treat HIV (i.e. iopinavir and riton­avir) and a steroid used to reduce inflam­ma­tion (dex­am­etha­sone) to assess their effec­tive­ness for treat­ing COVID-19.

Interdisciplinary and cross-sector col­lab­o­ra­tion and inno­va­tion are coming out in full force — and making an enor­mous dif­fer­ence at great speed to save the lives of those most badly affect­ed. For exam­ple, Formula One is work­ing with gov­ern­ment and health author­i­ties to boost the supply of much needed ventilators to the NHS and is repur­pos­ing some of its man­u­fac­tur­ing capac­i­ty to achieve this. And the British army is work­ing with the NHS to ensure that personal protective equipment supply chains are rapidly improved to address the short­ages of get­ting much needed pro­tec­tive gear to health work­ers. Supermarket chains are innovating to curb the ‘dark side’ of indi­vid­ual behav­iour as a result of stock­pil­ing by many shop­pers. Major risks to con­tin­ued supply may still exist, but inno­va­tion in supply chain man­age­ment is hap­pen­ing by the day.

Perhaps most inspir­ing of all is the social inno­va­tion I am wit­ness­ing in my own city, which pro­vides one story among count­less others. While it start­ed with WhatsApp groups in small local­i­ties like mine, the NHS has now extend­ed vol­un­teer­ing nation­al­ly. Our hearts have been warmed by sto­ries of indi­vid­u­als help­ing the most vul­ner­a­ble and needy to pro­vide basic sup­plies and offer­ing friend­ly con­ver­sa­tions to combat lone­li­ness due to social iso­la­tion, par­tic­u­lar­ly among those who lack the tech­nol­o­gy to con­nect. Educational aids abound to keep our chil­dren engaged in learn­ing and enter­tained. The spirit of com­mu­ni­ty is shin­ing through as much as pos­si­ble, with a good dose of humour to make the days a bit brighter.

The crit­i­cal links to make all of this happen appear to be a very clear sense of pri­or­i­ty and strong aware­ness of inter­de­pen­dence. It would be naïve to think that every issue facing soci­ety will in the future be met with the same col­lec­tive effort and urgency as is the case with COVID-19 at the moment. However, as a result of the crisis being faced now, people will hope­ful­ly all become more united by the pur­suit of col­lec­tive well-being. Innovating — indi­vid­u­al­ly and col­lec­tive­ly — could change the future. And hope­ful­ly the changes in atti­tudes, mind­sets, and ener­gies that are unit­ing people now will per­sist once this emer­gency is over.

If people can come togeth­er around COVID-19, and all devel­op­ments are show­ing that they can, then per­haps they can be equal­ly inno­v­a­tive in tack­ling many of the more silent ‘COVIDs’ of the time — i.e., the less imme­di­ate­ly impact­ful but equally urgent and important challenges asso­ci­at­ed with aging and frailty, mental health, cancer, comor­bidi­ties, and health inequal­i­ties as just some exam­ples. Along the way, lessons are being learned.

Sonja Marjanovic leads health inno­va­tion and health­care improve­ment research at RAND Europe.

Commentary gives RAND researchers a plat­form to convey insights based on their pro­fes­sion­al exper­tise and often on their peer-reviewed research and analy­sis.

Source: RAND

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