Implementing disruptive health innovations: Redefining traditional innovation vectors for impactful solutions Jayaram Subramanian*, Mark Barrow, Timothy.

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Implementing disruptive health innovations: Redefining traditional innovation vectors for impactful solutions Jayaram Subramanian*, Mark Barrow, Timothy Kenealy University of Auckland, New Zealand jram.subramanian@gmail.com Introduction and Objective The full potential of "digital revolution" can only be realised if it is effectively applied in routine clinical practice. However, enabling health practitioners to revise conventions and utilise new, disruptive, evidence-based interventions has been a persistent global challenge. Research indicates bridging this "implementation gap" can take atleast 17 years. Aim: How can we stimulate and better facilitate front-line health professionals to integrate innovations (e.g. digital tools) in diabetes and other chronic diseases care models for our vulnerable communities? Methods Multi-disciplinary theories guided this project: Consolidated Framework for Implementation Research, Diffusion of Innovations in Service Organizations Model, and Normalisation Process Theory. We purposively sampled “positively-deviant outlier” practices for rigorous qualitative study. Four exemplar primary care practices deemed successful in the uptake of new diabetes care interventions were selected after engagement with senior policy-makers and thought-leaders. Practices served the most socio-economically deprived communities of New Zealand (NZDep2013 Deprivation Index). In-depth, individual, face-to-face, semi-structured, interviews (each 45-90 mins.) with 11 clinicians (doctors, nurses, managers, and leaders) systematically explored facilitators for the uptake of new initiatives. Secondary data included Quality Improvement Collaboratives, policies, and practice visits. We abductively analysed data to develop a conceptual model. The transdisciplinary research team included a general practitioner and health systems researcher, a dentist and an educational sociologist and psychologist researcher. Results Central insights from our model fall under three major themes - inspiring innovation environment and culture, implementation processes, and innovation characteristics. Some emergent themes challenge conventional ideas and have the possibility to inspire new, practical ideas for impactful solutions – e.g. co-creative environment; interconnected, trans-disciplinary networking; open engagement with stakeholders; diversification of knowledge capital base; participatory, system-focussed and distributed leadership; encouraging dynamic, emergent operational modes; leveraging dynamic and reciprocal influence multiple actors have on each other’s priorities and interests etc. Outcomes and Impact We hope these new strategies (from a unique New Zealand perspective) would: stimulate new conceptual ideas – e.g. reframing poor strategies like “burning platform”; co-designing new models with improvement advisors help create an actionable tool to inspire all stakeholders (e.g. policy-makers, academia, R&D professionals) to gain meaningful improvements in real-world uptake of innovations; and identify future research priorities in this new area.