As one of the National Network of Public Health Institutes’ Regional Innovation Hubs, KHI supports public health innovation in HHS Region 7 for the Public Health Infrastructure Grant. Organizations, especially those operating in an interorganizational context such as the Innovation Hub model, often use a portfolio approach for innovation.1 A portfolio approach ensures that a mix of different types of innovations are incorporated, increasing the odds of breakthrough success. To support the development of an innovation portfolio, it is worth exploring how innovation is defined and different dimensions of innovation that can support the development of an innovation portfolio.
Innovation in Public Health
“Public health innovation can be defined as the creation and implementation of a novel process, policy, product, program, or system leading to improvements that impact health and equity.”2 Innovation represents a departure from the status quo and focuses on solving problems or creating value in new ways. Public health needs a more robust culture of innovation to respond swiftly to emerging threats like the COVID-19 pandemic and to address hard-to-solve problems, such as health inequities. Public health professionals also desire a more innovative workplace. However, the public health sector has been slow to adopt a mindset of innovation.2
To further characterize innovation, we’ll explore three dimensions of innovation, including: (1) the nature of the innovation, (2) the degree of change created by the innovation and (3) for whom the innovation creates value.3
Product or service innovation refers to the development of new products or services that meet stakeholder needs in new ways. The iPhone is an example of a product innovation because it revolutionized how people communicate. In public health, evidence-based practices, such as those recommended by the Community Guide, all started off as public health product or service innovations.
Process innovation refers to changes in the way products and services are produced to improve efficiency and quality. The assembly line in auto manufacturing is an example of a process innovation because it transformed how manufacturing was done. In public health, the move toward quality improvement methods, such as plan-do-study-act, is a path toward process innovation because of its focus on continuous learning and incremental improvement.4
Business model innovation refers to changes to the basic nature of an industry. Amazon is an example of this because it shifted the way people purchase goods. Business model innovations in public health include concepts such as the community chief health strategist and Foundational Public Health Services. These models are innovative because they have reframed what it means to be a high-achieving public health agency.
Degree of Change: Adoption, Creation and Disruption
Innovation adoption5 occurs when organizations incorporate existing ideas that alter their operations. In public health, for instance, a health department adopting PHAB accreditation exemplifies this. This type of innovation may represent a significant departure from the status quo for the health department but does not necessarily represent innovation in the broader public health system.
Incremental innovation5 involves the implementation of fresh ideas, usually resulting in small changes to what already exists. These innovations address specific problems for agencies or communities but typically don’t lead to broad changes. Because incremental innovations are brand new, they may be adopted by other organizations. In public health, examples include shifting community health planning online to boost engagement or employing geographic information systems for targeted resource allocation.2
Disruptive innovation, at the higher end of this spectrum, encompasses changes that can reshape entire industries. In public health, transformative ideas such as PHAB accreditation, Public Health 3.0, and the community chief health strategist are redefining the standards for excellence in public health agencies. Innovations from outside of public health, such as artificial intelligence, health care reforms, and changes to social policies also will reshape what is needed from the public health system and how it accomplishes its goals.
Level of Value: Users, Organizations, Systems and Society
User value: Successful innovations can meet a user’s needs in such a meaningful way they become part of their way of life.3 Think about how the iPhone affected how you communicate. Public health has a variety of users – patients and clients that receive direct services, partner organizations, and other stakeholders that use the data and information health departments produce. To create value for these stakeholders, public health leaders need to put themselves in the shoes of users to understand what they find valuable.
Organizational value: Successful innovations also can create value for the organization. By successfully innovating, organizations create a strong brand presence in a way that builds trust and connection. By building stakeholder support, this creates the means towards long-term success and viability.3 Public health leaders can create value for their organization by infusing their stakeholder’s needs across all their services and into their organizational essence.
Systems value: In addition to individual organizations, innovation can create value for an entire industry or system. A system refers to a group of organizations that are connected through value chains and interdependencies.3 Value is created for a system when the innovation shifts how the industry is valued as a whole or reshapes the nature of the industry. PHAB accreditation is an example of an innovation that has created value for the entire public health system because it has improved the recognition of public health in the eyes of stakeholders and reshaped public health standards in states such as Ohio, Colorado and Vermont, which mandated aspects of PHAB accreditation for health departments in their states.
Societal value: Successful innovations also can create value for society. As effective public health innovations are scaled up, their impact is compounded. This has the power to transform health across the country. Public health interventions, such as vaccination campaigns, traffic safety laws and tobacco prevention, were responsible for 25 of the 30 years of life expectancy gained in the 20th century. Innovations to address the social determinants of health and advance public health policy may help create sweeping improvements for the 21st century as well.
Conclusion
Fostering innovation in public health is essential for the sector’s evolution and effectiveness. A portfolio approach, supporting a mix of different types of innovations, may increase the odds of breakthrough success. By providing additional clarity around the different aspects of innovation, we hope to support public health leaders’ pursuits towards improvement and change. Our next post will continue to explore innovation, looking at organizational innovativeness and creating a culture of innovation in public health.
Faems, D., Van Looy, B., & Debackere, K. (2005). Interorganizational Collaboration and Innovation: Toward a Portfolio Approach. Journal of Product Innovation Management, 22(3):238-250. doi:10.1111/j.0737-6782.2005.00120.x. Retrieved Jan. 9, 2024, from https://onlinelibrary.wiley.com/doi/10.1111/j.0737-6782.2005.00120.x
Fraser, M. R. & Castrucci, B. C., eds. (2023). Building Strategic Skills for Better Health: A Primer for Public Health Professionals. Oxford University Press.
Den Ouden, E. (2012). Innovation design: Creating value for people, organizations and society. London: Springer.
Riley, W. J., Moran, J. W., Corso, L. C., Beitsch, L. M., Bialek, R., & Cofsky, A. (2010). Defining Quality Improvement in Public Health. Journal of Public Health Management and Practice, 16(1):5-7. doi:10.1097/PHH.0b013e3181bedb49. Retrieved Jan. 9, 2024, from https://bit.ly/48wSUKu
Dr. Kevin A. Kovach is an experienced epidemiologist and public health services and systems researcher. He currently serves as a Senior Analyst for Public Health Services and Systems at the Kansas Health Institute. Additionally, Dr. Kovach contributes his expertise as an adjunct assistant professor in the Master of Public Health program at the University of Kansas Medical Center. Dr. Kovach’s professional journey includes roles such as the Senior Manager for Population and Community Health at the American Academy of Family Physicians. In this role, he was instrumental in developing the Center for Diversity and Health Equity, advancing primary care and public health integration, as well as conducting applied research. He also has substantial experience working with state and local health departments in Michigan, Missouri, and Kansas. This work has helped shape his approach to research. Dr. Kovach is passionate about advancing health equity and committed to incorporating strategic management and innovation into public health practice. He is a graduate of Central Michigan University (BS), London School of Hygiene and Tropical Medicine (MSc), University of Illinois at Chicago (DrPH), and Kansas State University (Graduate Certificate).
