Coping with Changes and Innovation Strategy in Healthcare Implemented by the Ministry of Health and Prevention: Findings from the Literature : Hamdan Medical Journal

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Review Article

Coping with Changes and Innovation Strategy in Healthcare Implemented by the Ministry of Health and Prevention

Findings from the Literature

Alowais, Mariam1,2; Razzak, Hira Abdul3,

Author Information

1Public Health Sector, Technical Office, Ministry of Health and Prevention, United Arab Emirates

2Business and Quality Management, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates

3Statistics and Research Center, Ministry of Health and Prevention, United Arab Emirates

Address for correspondence: Ms. Hira Abdul Razzak, Statistics and Research Center, Ministry of Health and Prevention, P.O. BOX: 1853, Muhaisnah 2, Dubai, United Arab Emirates. E-mail: [email protected]

Received September 12, 2022

Received in revised form September 20, 2022

Accepted September 27, 2022

Hamdan Medical Journal 16(1):p 1-6, Jan–Mar 2023. | DOI: 10.4103/hmj.hmj_78_22
  • Open

Abstract

INTRODUCTION

Innovation refers to a new concept or approach that is introduced to an organization with the intention of creating benefits for the entity.[1] Innovation is usually considered an outcome of a strategic decision by an entity or is emerged as a good idea.[2] Innovation in healthcare can be employed to define various kinds of activities along a continuum from broad-based strategic change to merely doing small things in a different manner. The innovation strategy is defined as an idea of an organisation's development and activities in order to encourage, motivate, mobilise and attain technological or service advancements by investing in human and financial assets accompanied by the research and development activities. Numerous researchers have examined the correlation between innovation and business performance, with a particular emphasis on the positive impact it has on operational and financial dimensions. Moreover, they have observed significant difference in the results obtained depending on the type of innovation, as well as the size of the organization and the broader economy.[3,4] When applied to healthcare technology, innovations are mainly observed as innovative services or ways of delivering practice and innovative technologies. Eventually in healthcare, innovations often help the patient by improving their health or reducing illness or sufferings.[5] Innovation in healthcare supports in better interacting with patients (e.g., how individuals are heard or seen) and how services are being offered efficiently, safely and in an affordable manner.[6]

The process of innovation primarily depends on the size of an organisation.[7] Most of the innovations depend on the knowledge. The entrepreneurship and innovation primarily depend on the innovative individuals, their skills and knowledge.[8] Malerba and McKelvey[9] proposed that these individuals create knowledge-intensive innovative entrepreneurship.[9] The strategy of innovation means taking the most important, fundamental, forward-looking activities concerning the implementation of an innovative product, process or service, marketing method, etc., into the market or specific industry so as to meet the formerly unmet requirements of the buyers or meet these needs in an innovative way.[10] The innovation strategy defines the long-term goals, ways and scope to which innovations (process, product or organisational) will be applied to build a strategic advantage. Creating a culture of innovation across an organisation is not a quick or an easy task.[11] The ability to successfully implement innovative ideas encompasses a diverse set of skills and competencies, from market analysis to project and change management. One effective strategy is to determine the ways of creating the exceptionality of an organisation so that it stands out amongst competing entities operating in the market. The fluctuating market environment forces enterprises to continually adapt and change to the needs and expectations and develop the need to innovate.[12]

The quest for greater innovation at an international level in healthcare is long standing. The key stakeholders worldwide are continuously challenged by the complexity of the status quo and inertia, problems with spreading good ideas and space for trying out new things. This study examines this problem to find out evidence-based answers and solutions that are suitable for the current context of the United Arab Emirates (UAE). This study simplifies and summarises best practices and key concepts adopted by the Ministry of Health and Prevention (MOHAP) and from other relevant literature delivering a reachable document to guide stakeholders working across different industries and health and social care in the UAE.

The innovation is found to be the main component in economic as well as business development. The healthcare sector must be continuously up to date to fight against any emerging problem. This must be in line with the direction of the UAE's leadership towards making the UAE one of the most innovative countries across the globe. How healthcare organisations can most effectively as well as efficiently breathe life into and restore the pulse rate of the healthcare system by means of adopting the innovation strategies for improvement emerging as a critical resource competence management question for healthcare managers and funding bodies. This study, therefore, discusses the efforts put in by the MOHAP which is the umbrella and the federal regulatory body of the healthcare sector in the UAE. The study focuses on various aspects of innovation implementation within the organization, such as the efforts made to adopt and integrate innovation into organizational processes, how innovation was aligned with the strategic goals, the methods used to foster innovation and encourage employees to share their ideas, the tools and guidance provided, the innovation process followed, and the types of innovations generated, as well as the outcomes of these innovations.

METHODS

A short comprehensive review was conducted from electronic databases on information related to the innovation strategies in healthcare. A search of the medical literature through PubMed and Google Scholar was conducted using the following key terms: ‘Healthcare,’ ‘Innovation,’ ‘Services,’ ‘product,’ ‘System,’ ‘United Arab Emirates,’ and ‘Ministry of Health and Prevention.’ Articles written in English, conducted after the year 2010, related to innovation and mainly focusing on strategy were included. Articles excluded from the study were studies written in a language other than English, not related to innovation and those published before 2010. A Google web-based search using the key terms was used to help identify the most widely commercialised and highly regarded articles and papers. Finally, the information from both the PubMed and Google searches on innovations was reviewed. Additional literature was also extracted from the MOHAP website.

REVIEW OF LITERATURE

Innovation policy

MOHAP adopted and implemented an institutional model for innovation policy by applying a set of international system and specification which comprised the quality management system ISO 9001:2015, knowledge management system ISO 30401:2018, training management system ISO 10015:1999, innovation management system ISO 56002:2019, Afkari platform for managing the innovative ideas for employees and governmental excellence system. Through that policy, MOHAP committed to effectively implement innovation management systems and global standards along with periodically reviewing them to confirm its effectiveness and maintain a high level of accreditation and application. The senior management set a policy which focused on alignment with UAE's vision for innovation and implementation agenda, alignment with the MOHAP's objectives and strategy, building corporate culture based on innovation, offering framework and guidelines for achieving, setting and reviewing the goals for innovation management, offering continuous training, encouraging the use of idea management system, commitment to continuous improvement of the system and achieving effective partnership with the innovation related authorities in the country.

Creation and development of the innovation strategy

An innovation strategy involves continual learning, experimentation and adaptation. Good strategies tend to promote alignment amongst various groups within an entity, clarify priorities/objective and help to focus efforts around them.[13] Emphasising the importance of innovation, MOHAP's strategic direction adopted, along with the aim to make the UAE one of the most innovative countries in the world as part of the UAE Vision 2021 and the UAE National Innovation Strategy,[14] MOHAP has established their 'innovation health strategy' which in turn supports the innovation in the healthcare sector and aims to support the UAE in obtaining a position of a leading global destination for sustainable future in the smart healthcare.[15] This strategy encloses five pivots as mentioned in the [Figure 1]:

F1-1
Figure 1:
Five pivots of the innovation strategy

The MOHAP innovation strategy aimed to achieve improvement and development in many fields in healthcare and related technologies like in the field of diagnostic, pharmaceutical, treatment and health promotion. Moreover, a lot of the innovations in the ministry adopted the next technological generation including virtual reality (VR), artificial intelligence (AI), fourth industrial revolution and blockchain.[16]

The process of innovation applied in the Ministry of Health and Prevention and its potential triggers

In many ways, MOHAP has been fostering a culture of innovation in institutional work. In response to the national leadership's interest in innovation and the launch of the national innovation strategy in 2014, the ministry announced its own innovation strategy aimed at leading innovation towards world-class healthcare. To encourage innovation among its people, MOHAP has implemented various initiatives, such as the VR leadership lab, be bold program, masarik program, health innovation expo, and annual conference on innovation in cardiopulmonary resuscitation.[17]

System for innovation and idea management hub

In addition, in 2017, MOHAP introduced its idea management hub named 'Afkari', which is also referred to as an idea incubator. The system helped in empowering their employees to participate in the innovation movement by sharing their ideas and suggestions. Furthermore, it has sought to be a support for the research and development and prototyping. In addition to that, the ministry has initiated an assessment tool to acknowledge their employee's idea suggestion effort called 'Ideal employee prize' by recognising the count of the ideas and innovations presented by that employee.[18] To support their innovation system, Afkari 2.0 was launched in 2020, which took the platform into another level by including a collaborative digital space and gamification features to help share, discuss and implement ideas. This platform reflects the innovation value chain starting the inception of ideas, sharing and development, the evaluation and finally the execution.[19]

The process of innovation in the Afkari system consists of a six-step process as mentioned in [Figure 2]:

F2-1
Figure 2:
Six-step process of innovation

Furthermore, adding another important tool to drive out innovation in the organisation, the ministry was the first government entity to obtain a very important and prestigious accreditation certificate as high as the global conformity mark (GC-Mark) for innovation management (the highest certification level).[20]

Recognition and rewards

As mentioned in the previous literature, any organisation must find ways to reward and recognise innovation across all activities – either it may be research, educational, clinical or administrative.[21] This type of incentive should not be limited to monetary rewards but should also provide protected time or opportunities for professional growth, as well as recognition and celebration for innovative ideas. Moreover, recognition must include both large and small innovations and reward both individuals and groups. Considering that the results of innovation may be slow, rewards must be targeted towards creativity rather than production goals.

Hence, in a way to reward innovators and thinkers, the ministry honoured those employees who presented innovative projects and ideas in the innovation hub used in the entity 'Afkari' system, and innovative health research papers, with the presence of members of the ministry's leadership team to emphasise the importance of the innovative ideas presented by the employees.[22]

Creating a culture for innovation in the Ministry of Health and Prevention

Organisational culture plays a crucial role in shaping the healthcare service quality and healthcare delivery environment. Organisational culture is basically shared assumptions, beliefs and values that characterise a specific setting and influence routines, practices, as well as priorities.[23] There are several sides of organisational culture (e.g., innovation culture and safety culture).[24] MOHAP recognised the value of organisational culture, as cultures that value and support innovation can foster innovative behaviours, which in turn are associated with positive patient and staff outcomes across a healthcare sector.[25] Several significant innovations have emerged, among them:

  • The use of the most recent innovative solutions for heart disease treatment: MOHAP has accomplished a challenging cardiac surgery using the Bioadaptor DynamX technology, marking the first successful operation of its kind in the Middle East region. This disruptive innovation holds promising implications for future cardiac patients.[26]
  • The use of 4D bioprinting technology: Being the first in the region to use such an innovative technology, which is believed to be a radical innovation that opens the door in a whole new world of regenerative treatment of patients who need treatment like diabetic foot, chronic wounds and burns[27]
  • The utilisation of the training platform 'Maharati' to contain the repercussions of COVID-19: The training and development centre in MOHAP has been constantly updating the knowledge management page on COVID-19 which was used over 200,000 times. Moreover, many e-learning programs and trainings have been added to the Maharati training platform to enrich the employee's knowledge. This incremental innovation has been well utilised to ensure the continuity of training and development of the ministry's people regardless of the situation and their geographical location[28]
  • The implementation of the latest advanced surgical robot technology for performing sensitive surgeries in MOHAP: Incorporating this disruptive innovation will have a significant impact on the outcomes of surgeries and patient recovery in the future. It facilitates physicians in performing their duties more effectively and efficiently while reducing the likelihood of complications and adverse consequences for the patient.[15]
  • M-Gen technology: an AI-based smart diagnosing application project for genetic disease detection in newborn was announced during GITEX technology 2019. Where traditionally a blood sample is needed to perform the test to detect any genetic disease, this disruptive innovative new technology does not require blood test or any other tests to be conducted and provides immediate results[29]
  • 'Hayat' application: this radical innovative blockchain-based smart application, which is used for organ donation. Users can register themselves as donors of organs after death, and in turn, the application links all the health authorities with the federal authority for identity and citizenship to support the protocol of brain death and then links it to the registered donors[30]
  • 'Tateem' smart application, which is a disruptive innovative smart application where it was developed to help remind and simulate parents to follow up with their children's vaccination schedule[30]
  • The launch of TAQAT program: This disruptive innovation involves using an AI system to assess the competencies of MOHAP staff and match them with suitable vacancies and positions. It also aims to retain existing staff while enhancing their skills and expertise.[31]
  • 'AlinIQ clinical decision support (CDS)': An AI program which is a disruptive innovation that was announced in January 2020 in the Arab Health Conference, aiming to enhance the insights of patient-centric care. The AlinIQ CDS assists the healthcare providers' decision-making process for patient-specific decisions by the utilisation of AI and the access to the treatment protocols and guidelines according to the health status of the patient. Furthermore, the adoption of this innovation will enhance the quality of healthcare services, minimize medical errors, promote patient safety, and boost the productivity of healthcare facilities.[32]
  • Strap A2 device: being the first in the region to use this disruptive innovative technology. This new device is capable of performing a test to detect the seasonal influenza (a and b) viruses within a brief time frame that goes below 13 min, and yields the result in below 5 min. This new innovation helps MOHAP to increase the quality of their preventive healthcare services and control and reduce infectious diseases, and it also enhances the efficiency and effectiveness of the services.[33]

Limitation

The limitations of the study were (a) time constraints to conduct an interview study with the management and employees, (b) uncontrollable circumstances that conflicted with the time frame of the study and (c) limiting the search for studies conducted in English language only. There lies a possibility of missing few articles as some of the important databases were not searched. However, local journal articles were reviewed to obtain information restricted to an explicit geographical area. Future researchers should (a) investigate the relationship between strategies implemented by the middle managers and innovation implementation success measures and (b) explore the perceptions of middle managers with respect to the effectiveness of such strategies.

CONCLUSION

In conclusion, in line with the leadership directives and innovation strategy of the UAE, the objective was set to make the country a leading hub of innovation worldwide. The MOHAP – which is a federal regulatory body of the healthcare sector – has been very keen to adopt the innovation as a culture in their services and operations, by incorporating innovation in their organisational strategic direction. Furthermore, the UAE took a significant step towards realizing its leadership vision by announcing the innovation for health strategy and launching various initiatives to foster innovation among its citizens and integrate it into their organizational culture and practices. This included defining their innovation process, which aligns with the multi-stage process of different steps discussed in the literature. All of the above-mentioned helped with the development of the innovations in the MOHAP, including the use of the Bioadaptor DynamX for cardiovascular surgeries, the 4D bioprinting for the regenerative treatment, Maharati system for the continuous training and education and utilising it during the COVID-19 pandemic, the use of latest surgery robot for sensitive surgeries, M-Gen technology for discovering genetic disorders in newborn, Hayat application for organ donation, Tateem application for newborn vaccination schedule and many more.

Recommendations for action

Hence, the strategies defined in this research can be transferable and scalable. In future, the middle managers and leaders in other entities must examine their organisation performance measurement, leadership approach, reward management and staff engagement strategies. The middle managers must implement a participative employee-focused organisational culture that comprises collaboration, manager support structure, senior leader support, teamwork, performance-based rewards and recognition, learning and a safe climate. Moreover, it is essential to adopt a leadership approach that prioritizes employees and fosters a healthy, safe, and friendly work environment. This involves valuing employee input, promoting collaboration, encouraging accountability and ownership, establishing supportive managerial structures, utilizing situational-based leadership styles, implementing outcome-based accountability measures, and promoting open communication. An internal department-wise performance management system can also be implemented to motivate employees, with elements of continuous improvement and competency. Additionally, fostering employee engagement involves establishing trust-based relationships, promoting commitment, and providing reassurance to employees. Even though this strategy was implemented in the healthcare industry by the MOHAP, this strategy and learning can be transferable to any other industry. If an entity identified a gap in innovation implementation or performance, middle managers can adapt these strategies to implement successful changes to improve profitability and productivity. Hence, participative employee-focused organisational culture is the basis which must exist in an entity for all the other strategies to work. The incorporation of all the strategies that a middle manager may practice improves the engagement of the employees and the organisational profitability as well as performance.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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Keywords:

Healthcare; innovation; Ministry of Health and Prevention; services; system; United Arab Emirates

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