C3: Centre for Connected Care - Accelerating adoption and diffusion of patient-centric innovations

The C3 vision is to catalyse positive change in future health care, focusing on developing remote health care service. Our aim was to accelerate adoption and diffusion of patient-centric innovations that change patient pathways and delivery systems, empower the users, and increase growth in the healthcare industry. C3 addressed innovation from early design stages through R&D, system change efforts, procurement, adoption and scaling. C3 also researched the development, use and verification of new methods to support operational capabilities to perform innovation and adoption projects and processes in public healthcare. Hosted by Oslo University Hospital (OUS), C3 had 17 partners; five from research; University of Oslo (UiO), BI Norwegian Business School (BI), Oslo School of Architecture and Design (AHO), Akershus University Hospital (Ahus) and OUS; the latter two also user partners. Other user partners were six private companies and one public; Dignio, Accenture, Siemens Healthineers, Induct, Diffia, CGI and Sykehuspartner (Dynamic Precision left C3 year two), Sunnaas Rehabilitation Hospital and Revmatismesykehuset (left C3 year two) and the municipalities Oslo and Larvik. Finally, the business member associations Abelia and Norway Health Tech were part of C3. The broad participation resulted from the centre’s focus on collaborative interaction- and knowledge-driven innovation and adoption processes. C3s multi-disciplinary approach has addressed challenges in public healthcare innovation journeys, applying theories and methods from innovation and organizational change to their respective scientific frontiers to peer reviewed international journals and books. C3 service design research is based on creative developments of methods and experiments within a broader action research approach. One example is the introduction of “embedded service design labs” as temporary entities within hospitals/medical clinics. Another is the methods and theories developed to understand the underlying need of patients, next of kins and healthcare practitioners in the variety of new digital services. Informatics research contributed in two domains; firstly to explain systemic change effort challenges between existing technological bases and new platform-infrastructures needed to receive, adapt and scale emergent health services. This includes a PhD study of strategic public sector agencies and private supplier alignment challenges in efforts to develop new ICT platform-infrastructure standard interface solutions. The other domain was improved understanding of digital enabled health services adoption problems in home health. C3 has contributed to the understanding of patient-centricity and its implications for adherence to patients’ voices and implications for the design of new health services. Innovative enterprises are also studied, how they perform market entry efforts and interact with different public governance levels through emergent multi-staged decision-, investment-, and development- processes within both suppliers and buyer/user institutions. Public procurement of innovation research has provided an understanding of how relational procurement contracting over time may improve supplier-buyer alignment and facilitate more effective and efficient health services. Procurement contracts reported in the Doffin database constituted the quantitative data source and interviews with suppliers and buyers and from selected public-private innovation partnership cases the qualitative data. C3 has developed two methods to analyse and critically evaluate the actual and potential value of new health services. One is a radically new method, Step Up, for comprehensive early-stage health technology assessments (early HTA) of innovations aimed at supporting both innovators and decisionmakers in assessing such values in a systematic manner. It includes assessments of value to society, the healthcare system including patients and medical practitioners. Step Up has been thoroughly tested on multiple cases, published, and extensively discussed also internationally, and is in the process of being adopted as a standard method for early stage HTA analysis in several hospitals. The second method is digital simulation modelling to critically analyse organizational, logistical, and economic effects of organizational changes and new ways to organize resources in delivery of care. On 6 and 7 June 2023, C3 organized a closing conference to share research-based knowledge and launch C3's handbook for health innovation. The book will provides the tools you need to innovate and includes practical advice on how to involve stakeholders, make the right decisions throughout the innovation process and how to navigate through a public procurement and scale good solutions.

C3s forskning på fremtidige helsetjenester har vist seg å være tidsriktig og oppdatert. I dag tenker vi på helsetjenester som digitalisering, pasientsentrert omsorg og effektivitet, men inntil nylig var det ikke slik. Mennesker er kjernen i de system-endringene som må til, og organiseringen av C3 har vært avgjørende for å oppnå samarbeid med flere aktører. C3 har hatt en unik evne til å bringe ulike interessenter sammen rundt felles ambisjoner. Utviklingen av senteret reflekterer den betydelige innsatsen som kreves for først å bringe så mange partnere med ulike interesser sammen, og deretter samkjøre forståelse, dele utviklingsvisjoner, metoder og verktøy. Først da er det mulig å forhandle og styre de prosessene som trengs for å samordne interesser og prioriteringer.

There is a strong need for innovation in health care. Rising costs, an ageing population and increasing public expectations are making the current healthcare system unsustainable. Recent Norwegian white papers regarding coordination reform, quality of care and patient safety all address the need for innovative solutions, with particular focus upon the integration of people and technology. The Centre for Connected Care (C3) aims to succeed in accelerating adoption and diffusion of patient-centric innovations, i.e. innovations that change patient pathways and delivery systems and increases growth in the healthcare industry. We will use Oslo and Akershus University Hospitals, Oslo municipality, Larvik Municipality, Sunnaas and the hospital for rheumatic diseases as test beds for researchers and the commercial partners Siemens, Accenture, Dignio, Induct Software, Abelia, Dynamic Precision, Sykehuspartner and Oslo Medtech; will run patient-centric innovation projects. Important breakthroughs in knowledge often fail to be translated into medical practice. New creative solutions to patient-centric challenges and new technologies are not sufficient to make change happen. There is a clear need to investigate these problems to ensure adoption, diffusion and knowledge transfer such that they make a substantial difference. C3 will be hosted by Oslo University Hospital. Research partners will be Oslo School of Architecture and Design, University of Oslo and BI Norwegian Business School. C3 will be organized in three main themes and 11 work packages. The themes are: patient-centric healthcare delivery, Innovative infrastructure and interoperability and Commercialization, diffusion and adoption. Our vision is to tailor new service models closely around users actively engaged in their own health situation, improve efficiency and quality of care and contribute to economic growth in the health care sector.