Sustaining innovations in telecare and telehealth

Mike Clark 1

What is innovation?

Innovation is the successful introduction of something new and useful – a system, process, practice or technique. Innovation may be centred around developing or selling a new product or service or finding a solution to an end-user’s unmet needs. Incremental innovations can emerge from day-to-day practice while more radical innovations may only emerge from long-term research and development. In the interview essay you can see examples of innovation and how specific people bring to their work to improve productivity in certain areas or projects.

Technology and innovation are often interlinked. Such innovation may be led by supply (based on technological possibilities: Inclusive Learning Environments: Meeting Diverse Needs) or demand (based on social needs and market requirements) or a combination of both. Particular features of modern approaches to innovation include quality improvement, experimentation, ‘failing early but avoiding mistakes’ and finding cost efficiencies. Innovators can be individuals, teams and/or whole organisations. What separates innovation and innovators from those who simply have new ideas is the element of risk they take on to make them a reality.

Innovators and ‘champions’ tend to be motivated individuals and teams working in a supportive environment often with a strong sense of visionary leadership.

Measuring innovation can often be difficult particularly in organisations that do not make space for innovation to thrive and/or get anxious about the lack of results or outcomes.

The possibility of failure

There are two main reasons why innovation fails:

  • organisational culture – poor leadership, poor organisation, poor communication, poor empowerment of individuals, poor knowledge management
  • process issues – poorly defined goals, poor alignment of actions to goals, poor teamwork, poor monitoring of results and outcomes, poor communication and access to information, poor business case

Technology adoption, proof of concept and pilots

Innovation is often ‘piloted’ before ‘mainstreaming’ in order to identify risks and rewards. Often, the pilot may have different characteristics to a fully fledged service, but nevertheless breaks the ground – we have seen this with many telecare and telehealth services.

There are many stages to technology adoption from feasibility studies through to proof of concept and prototyping – it is often not an easy endeavour, particularly in a difficult economic climate. On the other hand, entrepreneurs and innovators can thrive in any environment.

Disruptive technologies and innovation

A disruptive technology is one where a new product or service appears that the market does not expect and is threatened by. A disruptive technology can come to dominate an existing market by filling a role that the older technology could not fill – such as digital photography replacing 35mm film. A truly revolutionary technology introduces products with highly improved new features into the market, such as the automobile or telephone. A sustaining technology improves the performance of established products or services. 2

The importance of horizon scanning

New technologies appear on a daily basis. 3, 4 We are all probably familiar with Google Health, Facebook, Twitter and the iPhone but what about Google Latitude, iPhone Apps and networking sites like Tyze?

  • Google Latitude is a ‘mobile friend finder’ launched in the USA and other countries. It enables smart-phone and computer users to triangulate the whereabouts of family and friends. Such an innovation could be invaluable for supporting people with dementia in the community, though it also raises privacy issues.
  • iPhone Apps are free or low cost applications for the iPhone or iTouch, including those that can track your blood pressure, medications, weight and fitness programmes, as well as sending data to various recipients for remote monitoring. Examples include Illness Tracker, weightbot, Distance Meter, BP Charter, and Glucose Charter. The ability to connect the phone to medical devices (eg, a glucose monitor) was demonstrated in the Apple software upgrade on 17 March 2009.
  • Tyze is a social networking site that enables patients, carers, and families to build a ‘community’ to help support someone’s care through advocacy, monitoring, or simple companionship. This may provide an innovative approach to enabling the Department of Health’s commitment to creating a network of local and national support groups for people with long-term care needs as part of its Your Health, Your Way strategy.

In the USA, telemedicine consultations – that allow patients to talk with doctors through online video, online chat or phone – are now a regular part of care. Soon, however, physicians might also review patients' personal health records using Microsoft's HealthVault and so prescribe medications.

As telecare and telehealth champions actively promote and build awareness of new services, global organisations are developing disruptive technologies that could radically alter how services are delivered in the future. It is likely that technology ‘replacement cycles’ will reduce as new products and services become available. With commissioners of new technologies concerned with ‘future-proofing’ their investments, horizon scanning has never been so important.

Mike Clark is co-project lead for WSDAN


  1. This feature is based on a presentation made by Mike Clark at a recent meeting of the WSDAN members in February 2009.
  2. For a discussion on disruptive technologies we recommend ‘The Innovator's Dilemma’ by Clayton Christensen, 2005.
  3. A round-up of new announcements on health and social care technologies appears monthly in these DH-sponsored telecare newsletters.
  4. WSDAN does not endorse any individual products or supplier. References to brand names are for illustrative purposes only.