Submit a Manuscript to the Journal
Innovation: Organization and Management
For a Special Issue on
Rethinking Medical Innovation: Organizing R&D, Responding to Crisis, Delivering Health Services
01 December 2021
Rethinking Medical Innovation: Organizing R&D, Responding to Crisis, Delivering Health Services
The objective of this SI is to broaden and deepen our knowledge about new developments and changes in the way medical innovation occurs. By this, we mean innovation, entrepreneurship and the organization of research and development in the context of healthcare organizations, the medical devices and pharmaceutical industries as well as the broader field of medicine and life-sciences. We invite submissions studying the topic of “Rethinking Medical Innovation” in a variety of contexts including businesses, academia, governments, healthcare providers, and not-for-profit organizations.
We must rethink how, why, and when medical innovations occur and are diffused in society. Traditional ways of innovating in the medical sphere are being challenged. Specific challenges include scientific and technological progress in bio-medical and related disciplines such as personalized therapies (Denicolai and Previtali 2020) as well as digitalization and the use of artificial intelligence (Schneider et al. 2020). Moreover, the disruptive element of the global COVID-19 pandemic as a crisis event opens up new opportunities. This has raised questions about the potential for a redesign of where and how medical innovation is conducted (George, Lakhani, and Puranam 2020). Although some actions may stimulate innovation, others may reduce the ability of organizations to dedicate scarce resources to medical innovation (Gross and Sampat 2020; Paunov 2012; Archibugi, Filippetti, and Frenz 2013).
Theme 1: The Changing Business Organization of Medical Innovation and R&D
New technologies and business models, as well as the global impact of the current health crisis, have challenged the organization of medical innovation seen from a business perspective. Changes are occuring, even though the bio-pharmaceutical industry has long relied upon extensive knowledge relationships between large firms, small firms and universities to innovate (McKelvey 1996). In recent years, many of the major firms have reviewed their product and service portfolios in order to become leaner and more focused companies while many smaller players seek to grow their portfolios (Gautam and Pan 2016). Although there have been concerns that companies are putting less emphasis on contributing to science and the underlying knowledge basis (Rafols et al. 2014), other research has demonstrated how companies are highly involved in partnering and contributing to scientific knowledge within focal treatment areas (McKelvey and Rake 2016, 2020).
Business innovation may occur in many dimensions, seen also in the global COVID-19 pandemic. Shortages of critical medical supplies encouraged a host of non-traditional actors to engage in medical innovation, including actors from outside industry (Harris et al. 2020; Sinha, Bourgeois, and Sorger 2020). Many of these new actors have advanced new models of innovation, including “frugal” innovation that prioritizes rapid and high quality response under constraints (Harris et al. 2020), sustainable innovation, which prioritizes environmental responsibility, resilience and reusability (Wuyts et al. 2020), and free and open source (Maia Chagas et al. 2020) and “open” innovation, which prioritizes opportunities for accessible and distributed research, development and production (Chesbrough 2020). Organizational redesigns of this nature may be facilitated by digital novel technologies such as digital health and artificial intelligence (Fleming 2018), and 3-D printing and other distributed production methods.
This first SI theme on the changing business organnization of medical innovation and R&D includes:
- Relationships between specialization and adaptability between actors in an ecosystem when innovating
- Why, how, and when companies encourage entrepreneurship and the development of new business models
- New collaboration and organizational forms of medical R&D and innovation
- Foundations for accelerated medical innovation, including role for digital technologies
Theme 2: Responding to Crisis with Medical Innovation
A crisis is commonly understood as a surprising event that disrupts organizational practices and requires rapid response (Williams et al. 2017). Such unanticipated events include economic shocks, health-related events, terrorist attacks, accidents, or technology failures. The global COVID-19 pandemic, and the need for rapid responses to it, have been a trigger event as a crisis.
The necessity of developing fast responses to a crisis is in sharp contrast to the conventional innovation processes in the corresponding industries, involving years of pre-clinical and clinical development as well as costs of often several hundred million US dollars or even more (DiMasi, Grabowski, and Hansen 2016). In the context of the profound shortage of vital yet “mundane” (Michael 2003) medical supplies (e.g., personal protective equipment, hand sanitizer, diagnostic reagents), the innovative responses of firms and other actors in addressing these shortages in the recent global health crisis (Harris et al. 2020), suggest that innovation scholars’ traditional disinterest in low-technology health innovation (Miller and Lehoux 2020) may warrant revision. Repurposing existing medications as treatment options for new diseases or diseases with unmet therapeutic needs requires further attention (Hanisch and Rake 2021).
This second SI theme on responding to crisis with medical innovation includes:
- Responding, avoiding negative consequences, and creating new conditions for innovation
- Analysis of the medium- and long-term consequences of a crisis for future organization of medical innovation processes
- Whether the extraordinary efforts in one crisis can be transferred to more normal situations
Theme 3: Innovation Policies for Medical Innovation
There are debates about whether innovation policy should augment existing political economy goals, as compared to more directed policy. Within the debates about mission driven and “directional” innovation (Mazzucato and Li 2021), scholars increasingly question the extent to which existing scientific and technological progress actually responds to population health needs, given the persistence of neglected diseases (e.g., in the global south) and conditions (e.g., multidrug resistant antibiotics), high product prices and an increasingly financialized biomedical innovation. Active industrial policy is also back on the agenda (Chang and Andreoni 2021). This is leading to growing pressures both for and against more localized /regionalized, distributed and resilient medical supply networks (Meyer 2020), with implications for firms, policy makers and innovation scholars. Moreover, whether policy should support basic, applied or experimental development for medical innovation remains an unanswered question requiring future reseach (Gulbrandsen and Kyvik 2010).
Policy questions have achieved greater prominence recently, during the pandemic, which heighten awareness of global dependence on a robust health innovation system. On the one hand, the rapid development of a large number of highly effective vaccines, including those using radically new mRNA vaccine technology, highlighted the system’s considerable strengths (Irwin 2021). On the other hand, critical shortages of a host of “mundane” yet vital health technologies (e.g., personal protective equipment, medical supplies), and profound global inequities in access to vaccines, have also highlighted the system’s significant weaknesses (Miller et al. 2020; Irwin 2021).
This third SI theme on innovation policy for medical innovation includes:
- Studying the consequences of the benefits and returns of active industrial policies for medical innovation
- Whether, why and how policy makers can support the resilience of global, regional, or local health innovation systems and the potential downsides of these policies
- Longer-term policy issues affecting the global development and access of medical innovations
Theme 4: Hospitals and Patients in Medical Innovation and Delivery of Care
Hospitals are not only adopters and users of innovations but also play an important role for medical innovation as they are R&D performing institutions. They conduct clinical research and develop new medical procedures (Thune and Mina 2016). Because ‘learning in practice’ is one of three overlapping pathways for medical advance, alongside developments in scientific knowledge and technological progress (Morlacchi and Nelson 2011), innovation within care delivery organizations is critical to the production of effective medical artifacts that respond to patient need (Nelson et al. 2011). Knowledge networks including those in clinical trials and product innovation can also influence initiation and care delivery (Rake, D’Este, and McKelvey 2021; Thune and Gulbrandsen 2017).
Previous research has shown that some contact with patients is beneficial for innovation, although commitment to R&D ultimately declines with a risk of hindering innovation if the commitment to patient care increases (Llopis and D’Este 2016). Hence, on the one hand hospitals and medical care providers may need to expand patient care capacity, due to political decisions as well as healthcare needs, but may reduce their innovation activities. On the other hand, expanding patient care may open up opportunities for developing new organizational responses, new treatments, and new ways of addressing diverse population and public health needs.
This fourth SI theme on hospitals and patients in medical innovation and delivery of care includes:
- Whether and how hospitals (and other providers of medical care) organze their work, and can shift their innovation activities in response to internal and external decisions and articulated needs
- Relationship between the work environment in hospitals and other care providers
- The roles of hospitals in stimulating new organizational forms for medical innovation
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