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Procurement of ehealth solutions workshop 7 October 2010, Brussels, Belgium

Procurement of ehealth solutions workshop 7 October 2010, Brussels, Belgium. S ØNDERBORG P ARTICIPATORY I NNOVATION RE SEARCH CENTRE Cross-disciplinary research 18 professors & postdocs 8-10 PhD students. Public Procurement of e-Health in Denmark: the Case of the Patient Briefcase.

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Procurement of ehealth solutions workshop 7 October 2010, Brussels, Belgium

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  1. Procurement of ehealth solutions workshop7 October 2010, Brussels, Belgium SØNDERBORG PARTICIPATORY INNOVATION RESEARCH CENTRE Cross-disciplinary research 18 professors & postdocs 8-10 PhD students Public Procurement of e-Health in Denmark: the Case of the Patient Briefcase Max Rolfstam maxr@sam.sdu.dk

  2. Public Procurement of Innovation (PPI) Purchasing activities carried out by a public agency that lead to innovation Satisfies a social need not previously satisfied by the market Supplier needs to conduct Research and Development in order to deliver PPI  Private sector R&D  Competitive advantage  Growth PPI  More efficient public services  Saving public resources … Firm growth  More tax-money  Increased public purchasing power  …

  3. European Public Procurement Policy Development Pre-2000: Efficiency, competition, reduce public spending, common market 2000: Lisbon European Council vision  the most advanced knowledge based economy. 2002:  R&D 3% of EU GDP, “impulse needed” 2003: public sector as “launching customer” 2005: public authorities “big market players” 2006: “public procurement to drive demand for innovative goods” to create lead markets; pre-commercial procurement a missing link 2007: European Council published a guide on dealing with innovative solutions in public procurement Recent: OMC-PTP, STEPPIN, EC Expert Group on Public Procurement of Innovation and Risk Management, Regional collaborations… 2009: The EU Parliament noted “that strengthening pre-commercial procurement remains one way among many for Member States to raise their game in innovation and research…”

  4. The PreCo Project Enhancing Innovation in Pre-commercial Public Purchasing Processes • The overall objective of the project is to support public authorities in undertaking pre-commercial procurement that stimulate innovation and citizen participations. To identify ongoing best practice examples across of PCP projects, to support the ongoing and future PCP activities of public authority participants and other pioneers by addressing their specific needs. Partners: Culminatum Innovation Oy Ltd (Fi), Alfamicro- Sistemas De Computadore S (Pt), EPMA- Agentura pro evropske projekty & management (Cz), Fundacion Comunidad Valenciana- Region Europea (Es), Syddansk Universitet (Dk), Vysocina Kraj (Cz), Aalto University School of Economics (Fi), Copenhagen Living Labs Aps (Dk), Amsterdam Innovation Motor (Nl), Unione Regionale Delle Camere Di Commercio Industria Artigianato E Agricoltura Del Veneto (It). Funded by FP7 of the EC.

  5. Denmark’s public procurement of innovation policy development • - Danish policies on public procurement up to 2005 mainly concerned efficiency aspects (Edler et al, 2005). • - The relatively modest interaction between the public sector and private companies was also identified as a problem to be addressed in future innovation policies (Innovationsrådet, 2004). • - Now: Public procurement as an innovation policy instrument is gaining increasing attention (e.g. The Danish Society of Engineers, National Procurement Inc, Danish Enterprise and Construction Authority, Unit for welfare technology innovation at Region of Southern Denmark). • - The Danish health sector: interest for demographic reasons. Increasing number of elderly people should be taken care of by fewer numbers of staff. This can be done only if innovation is achieved (e.g. Voss, 2009).

  6. The Patient Briefcase (Prel. Findings) • A Portable Telemedicine System • - The patient brief case • - Work station for medical staff • The System Enables • - Live medical staff and patient video conference • Heart monitoring, blood pressure, blood analysis • Data transmissions from the medico technical equipment that’s plugged in to medical staff • Supplier: Danish company: Medisat • Procurer: (initially) Svendborg Hospital and Odense Hospital, Denmark Time line: 2006: Initial ideas 2006/2007: First patient 2008: Regional contract 2009: 975 patients 2010: National contract (?): International contracts Budget: 6 -10 M DKK (1,2 M DKK (public) project funding, the rest from the supplier)

  7. Effects of the Patient Briefcase Distance care: Patients can be sent home within 48 hours instead of 6-7 days Release of hospital beds Reduction of workforce Allowing treatment in the home of the patient Increased quality of life for patients Increased effects of health care

  8. 1) Initial “Lead user” specifications: Simple Not (appear as) a computer Enable communication Be able to measure things Transmit pictures and sound Sensitive data Be handled by 75 year Be robust - Portable – Hygienic User driven/ Participatory innovation 2) Input from medical staff (nurces): Close collaboration with supplier: What does (s)he need to see? What can the patient manage? How to appear in front of three computer screens displaying different data in the same time as engaging in live conversation with patient (“TV host(ess)”). a) First prototype: Only two buttons! On/off and Emergency call. 3) Input from patients in development lab. Size? Picture quality? Sound quality? Patients asked to carry out certain tasks. And asked afterwards on what they lacked. b) Five prototypes: Trial consultations for selected patients 4) Questionnaireby patients and nurces c) New prototype: Volume button added

  9. What kind of innovation? • Demand-driven innovation (local demand) • Product innovation/ Service innovation/ Process Innovation • New to the country/ new to the world(?) • Established a new market (leasing of brief case systems) • Changed routines in health service delivery • a) Distance health service b) Medical staff as “TV hosts/ hostesses” • Supplier used existing technological competencies in a new field • Supplier did something they hadn’t done before • Radical innovation • Originally for treatment of COPD (Chronic Obstructive Pulmonary Disease) – spillover to other treatments • “Local learning/innovation” – Global market (?)

  10. Experiences (selected) • - Mid term evaluation: Be prepared to close down projects (and allocate • resources to projects judged to be more promising) • - Consider implementation/ diffusion of the final product already at the development stage • - Business model: Leasing of a service, not a procurement of a product • - Slow decision processes within the public administration • - Difficult to set price on an innovative product never used before • - Lack of legal competence in hospital to set up contracts • - Lack of understanding for dealing with public sector, e.g. demand for documentation (Interviews and Erhvervs- ogByggestyrelsen, 2009) Success factors for the Patient Briefcase: An innovation friendly workplace Local champion(s) Supplier Competence for user producer interaction A supplier willing to take financial risks Trust between procurer and supplier

  11. Success Factors for Public Procurement of Innovation Following recent research on success stories and failures: • Expertise on public procurement procedures and relevant law, Technical competence for specification, Coordinating competence for co-operative procurement, General project management skills, Allocation of resources for public procurers, Political support, Risk management, Public support, Supplier side understanding of public procurement procedures, Institutional coordination, Understanding of when there is (not) a system failure, Method development, for instance pre-commercial procurement (Rolfstam, 2007; 2009; 2010) This case underscores the importance of having an innovation-supporting organisation that can help transition from local innovation to global.

  12. Innovation support organisation!

  13. Institutional understanding relevant for increasing the use of public procurement as a means to stimulate innovation Following Coriat & Weinstein (2002) Institutions: Sets of habits, routines, rules, norms and laws, which regulate the relations between people and shape human interaction (North, 1990, p. 3; Johnson, 1992, p. 26) . …understood as an institutionalised ‘effect’ or “goal orientation” of the organization (Rolfstam, 2009).

  14. Pre-commercial Procurement Utilizing the R&D-exception…

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