||Transformation Strategy for Reverse Healthcare Frugal Innovation
||Department of BioMedical Engineering
||Tieu Nguyen Minh Duy
Frugal medical device
Strategic pathway suggestion
Global health care systems are aiming to expand the access of patients as well as to improve the quality and the efficiency of health care services in the face of increasing financial constraints and growing demand of people. In response to that demand, many innovators in low-income markets have developed many solutions including products and services which are affordable, tailored to the needs and able to deliver healthcare services at a fraction of the cost, termed Frugal Innovation. There are many suggestions that these ideas can be applied to the high-income market, transfer to a concept labeled as Reverse innovation since Frugal innovation seems to be able to solve many problems of the weakness in the quality of healthcare services in both developing and developed market. Although frugal innovation is becoming a topical phenomenon, the current status of Frugal Innovation Literature is largely dominated by theoretical studies. There is still a big gap in the diffusion of Frugal innovation in academic research. The purpose of this study is investigating the transformation strategy for Reverse Healthcare Frugal innovation by bringing Frugal medical device from rural market to urban market. In order to identify the strategy for medical device companies, a questionnaire was developed, then distributed to the population of physician, medical staff, scholar, distributor, manufacturer and the collected data were analyzed by Decision-making Trial and Evaluation Laboratory (DEMATEL) method to construct Importance-Satisfaction Analysis (ISA) and Network Relationship Map (NRM). This study provides the panoramic strategic solutions with optimal pathways to fulfill the criteria for Frugal innovation medical device to expand the market based on their relationships and levels of importance and satisfaction.
LIST OF TABLES vi
LIST OF FIGURES vii
CHAPTER ONE 1
1.1 Research background 1
1.2 Research objective and motivation 3
1.3 Study process and method 4
1.4 Organization of the study 6
CHAPTER TWO 7
LITERATURE REVIEW 7
2.1 Reverse Innovation 7
2.2 Healthcare Innovation 8
2.3 Frugal Innovation 10
2.3.1 Frugal Innovation Definition 10
2.3.2 Differences of Frugal innovation: 11
2.3.3 Frugal Innovation in Healthcare industry 12
2.4 The transformation of Healthcare Frugal innovation to Reverse innovation 13
2.5 Evaluation model of Reverse Healthcare Frugal innovation 15
2.5.1 User Experience aspect (UE) 18
2.5.2 Product Benefit aspect (PB) 18
2.5.3 Safety and Reliability aspect (SR) 18
2.5.4 Brand Name Effect aspect (BE) 19
2.5.5 Social Influence aspect (SI) 19
CHAPTER THREE 21
RESEARCH MEASURES AND METHODOLOGIES 21
3.1 Stakeholder Analysis 21
3.2 Sample description 22
3.3 Study design and Methodologies 23
3.3.1 Study design 23
3.3.3 Content Analysis 26
3.3.4 Decision-Making Trial and Evaluation Laboratory (DEMATEL) 27
3.3.5 Network relationship map (NRM) 30
CHAPTER FOUR 31
PRACTICAL STUDY AND RESULTS 31
4.1 Content Analysis 31
4.2 Questionnaire analysis 35
4.3 ISA-NRM analysis 35
4.3.1 General aspect 36
4.3.2 User Experience aspect (UE) 39
4.3.3 Product Benefit aspect (PB) 42
4.3.4 Safety and Reliability aspect (SR) 45
4.3.5 Brand Name Effect aspect (BE) 48
4.3.6 Social Influence aspect (SI) 51
CHAPTER FIVE 54
DICUSSION AND CONCLUSION 54
5.1 Discussion 54
5.1.1 General aspect 54
5.1.2 User Experience aspect (UE) 56
5.1.3 Product Benefit aspect (PB) 57
5.1.4 Safety and Reliability aspect (SR) 58
5.1.5 Brand Name Effect aspect (BE) 59
5.1.6 Social Influence aspect (SI) 60
5.2 Managerial Implication 66
5.3 Theoretical Implications 66
5.4 Conclusion 68
5.5 Limitation and Future Research 69
Agarwal, N., & Brem, A. (2012). Frugal and reverse innovation-Literature overview and case study insights from a German MNC in India and China. Paper presented at the 2012 18th International ICE Conference on Engineering, Technology and Innovation.
Agarwal, N., Brem, A., & Grottke, M. (2018). Towards a higher socio-economic impact through shared understanding of product requirements in emerging markets: The case of the Indian healthcare innovations. Technological Forecasting and Social Change, 135, 91-98.
Andersson, S., & Persson, G. (2019). The Country-of-Origin Effect in the Personal Care Market: A study on Swedish consumers’ perception of Chinese products. In.
Angot, J., & Plé, L. (2015). Serving poor people in rich countries: the bottom-of-the-pyramid business model solution. Journal of Business Strategy, 36(2), 3-15.
Appleby, J. (2013). Spending on health and social care over the next 50 years. Why think long term, 10.
Arney, D., Pajic, M., Goldman, J. M., Lee, I., Mangharam, R., & Sokolsky, O. (2010). Toward patient safety in closed-loop medical device systems. Paper presented at the Proceedings of the 1st ACM/IEEE International Conference on Cyber-Physical Systems.
Bank, W. (2017). World Bank country and lending groups. In: World Bank Data Help Desk Washington (DC).
Beattie, M., Murphy, D. J., Atherton, I., & Lauder, W. (2015). Instruments to measure patient experience of healthcare quality in hospitals: a systematic review. Systematic reviews, 4(1), 97.
Bergsland, J., Elle, O. J., & Fosse, E. (2014). Barriers to medical device innovation. Medical devices (Auckland, NZ), 7, 205.
Bianchi, C., Bianco, M., Ardanche, M., & Schenck, M. (2017). Healthcare frugal innovation: A solving problem rationale under scarcity conditions. Technology in Society, 51, 74-80.
Bound, K., & Thornton, I. W. (2012). Our frugal future: Lessons from India's innovation system: Nesta London.
Bourne, L. (2016). Stakeholder relationship management: a maturity model for organisational implementation: Routledge.
Brem, A., & Ivens, B. (2013). Do frugal and reverse innovation foster sustainability? Introduction of a conceptual framework. Journal of Technology Management for Growing Economies, 4(2), 31-50.
Chen, P.-T. (2018). Medical big data applications: Intertwined effects and effective resource allocation strategies identified through IRA-NRM analysis. Technological Forecasting and Social Change, 130, 150-164.
Corsi, S., Di Minin, A., & Piccaluga, A. (2014). Reverse innovation at Speres: A case study in China. Research-Technology Management, 57(4), 28-34.
Cossío-Silva, F.-J., Revilla-Camacho, M.-Á., Vega-Vázquez, M., & Palacios-Florencio, B. (2016). Value co-creation and customer loyalty. Journal of Business Research, 69(5), 1621-1625.
Curtis, S., & Leonardi, G. S. (2012). Health, wealth and ways of life: what can we learn from the Swedish, US and UK experience? Overview. Social science & medicine (1982), 74(5), 639.
Davvetas, V., Sichtmann, C., & Diamantopoulos, A. (2015). The impact of perceived brand globalness on consumers' willingness to pay. International Journal of Research in Marketing, 32(4), 431-434.
Desyllas, P., Miozzo, M., Lee, H. f., & Miles, I. (2018). Capturing Value from Innovation in Knowledge‐Intensive Business Service Firms: The Role of Competitive Strategy. British Journal of Management, 29(4), 769-795.
Dictionary, O. E. (2017). Oxford living dictionaries. In: Oxford University Press. Retrieved from https://en. oxforddictionaries. com ….
Fredriksson, E., & Tömmervik, J. (2014). Frugal is the new innovative thinking: A qualitative study of frugal innovations and sustainable development in resource-poor environments. In.
Füller, J., & Matzler, K. (2008). Customer delight and market segmentation: An application of the three-factor theory of customer satisfaction on life style groups. Tourism management, 29(1), 116-126.
Gottlieb, S., & Makower, J. (2013). A role for entrepreneurs: an observation on lowering healthcare costs via technology innovation. American journal of preventive medicine, 44(1), S43-S47.
Govindarajan, V., & Euchner, J. (2012). Reverse innovation. Research-Technology Management, 55(6), 13-17.
Govindarajan, V., & Ramamurti, R. (2011). Reverse innovation, emerging markets, and global strategy. Global Strategy Journal, 1(3‐4), 191-205.
Grover, A., Caulfield, P., & Roehrich, K. (2014). Frugal innovation in healthcare and its applicability to developed markets. In British Academy of Management.
Gurtner, S., & Soyez, K. (2015). Challenges and opportunities in health care management: Springer.
Hasan, M. R., Lowe, B., & Rahman, M. (2017). Visual cues and innovation adoption among bottom of the pyramid consumers. Qualitative Market Research: An International Journal, 20(2), 147-157.
Hassenzahl, M., & Tractinsky, N. (2006). User experience-a research agenda. Behaviour & information technology, 25(2), 91-97.
Herzlinger, R. E. (2006). Why innovation in health care is so hard. Harvard business review, 84(5), 58.
Holsti, O. R. (1969). Content analysis for the social sciences and humanities. Reading. MA: Addison-Wesley (content analysis).
Horn, C., & Brem, A. (2013). Strategic directions on innovation management–a conceptual framework. Management research review, 36(10), 939-954.
Hossain, M. (2018). Frugal innovation: a review and research agenda. Journal of Cleaner Production, 182, 926-936.
Hossain, M., Simula, H., & Halme, M. (2016). Can frugal go global? Diffusion patterns of frugal innovations. Technology in Society, 46, 132-139.
Hoyer, W. D., & MacInnis, D. J. (2008). Pieters. Consumer behavior.
Hsu, C.-W., Kuo, T.-C., Chen, S.-H., & Hu, A. H. (2013). Using DEMATEL to develop a carbon management model of supplier selection in green supply chain management. Journal of Cleaner Production, 56, 164-172.
Immelt, J. R., Govindarajan, V., & Trimble, C. (2009). How GE is disrupting itself. Harvard business review, 87(10), 56-65.
Jiang, Y., & Lu Wang, C. (2006). The impact of affect on service quality and satisfaction: the moderation of service contexts. Journal of Services Marketing, 20(4), 211-218.
Kaplan, G. A. (2012). Economic crises: some thoughts on why, when and where they (might) matter for health--a tale of three countries. Social science & medicine (1982), 74(5), 643-646.
Kassarjian, H. H., & Kassarjian, W. M. (1988). The impact of regulation on advertising: A content analysis. Journal of Consumer policy, 11(3), 269-285.
Katsumata, S., & Song, J. (2015). The reciprocal effects of country-of-origin on product evaluation. Asia Pacific Journal of Marketing and Logistics.
Kendler, J., & Strochlic, A. Y. (2015). Usability testing of medical devices: CRC press.
Kim, R. H., Gaukler, G. M., & Lee, C. W. (2016). Improving healthcare quality: A technological and managerial innovation perspective. Technological Forecasting and Social Change, 113, 373-378.
Lai, M.-C., Chou, F.-S., & Cheung, Y.-J. (2013). Investigating relational selling behaviors, relationship quality, and customer loyalty in the medical device industry in Taiwan. International Journal of Business and Information, 8(1).
Länsisalmi, H., Kivimäki, M., Aalto, P., & Ruoranen, R. (2006). Innovation in healthcare: a systematic review of recent research. Nursing science quarterly, 19(1), 66-72.
Lee, W.-S., Huang, A. Y., Chang, Y.-Y., & Cheng, C.-M. (2011). Analysis of decision making factors for equity investment by DEMATEL and Analytic Network Process. Expert Systems with Applications, 38(7), 8375-8383.
Liljegren, E. (2006). Usability in a medical technology context assessment of methods for usability evaluation of medical equipment. International Journal of Industrial Ergonomics, 36(4), 345-352.
Lim, C., Han, S., & Ito, H. (2013). Capability building through innovation for unserved lower end mega markets. Technovation, 33(12), 391-404.
Lin, C.-L., Shih, Y.-H., Tzeng, G.-H., & Yu, H.-C. (2016). A service selection model for digital music service platforms using a hybrid MCDM approach. Applied Soft Computing, 48, 385-403.
Lowe, B., & Alpert, F. (2015). Forecasting consumer perception of innovativeness. Technovation, 45, 1-14.
Martilla, J. A., & James, J. C. (1977). Importance-performance analysis. Journal of marketing, 41(1), 77-79.
Martin, J. L., Clark, D. J., Morgan, S. P., Crowe, J. A., & Murphy, E. (2012). A user-centred approach to requirements elicitation in medical device development: A case study from an industry perspective. Applied ergonomics, 43(1), 184-190.
Miller, F. A., & French, M. (2016). Organizing the entrepreneurial hospital: Hybridizing the logics of healthcare and innovation. Research Policy, 45(8), 1534-1544.
Penchansky, R., & Thomas, J. W. (1981). The concept of access: definition and relationship to consumer satisfaction. Medical care, 127-140.
Radjou, N., & Prabhu, J. (2015). Frugal Innovation: How to do more with less: The Economist.
Rajan, P. V., Kramer, D. B., & Kesselheim, A. S. (2015). Medical device postapproval safety monitoring: where does the United States stand? Circulation: Cardiovascular Quality and Outcomes, 8(1), 124-131.
Rao, B. C. (2013). How disruptive is frugal? Technology in Society, 35(1), 65-73.
Resnic, F. S., & Majithia, A. (2018). Postmarket medical device safety: moving beyond voluntary reporting. In: BMJ Publishing Group Ltd.
Revicki, D. A., Osoba, D., Fairclough, D., Barofsky, I., Berzon, R., Leidy, N., & Rothman, M. (2000). Recommendations on health-related quality of life research to support labeling and promotional claims in the United States. Quality of Life Research, 9(8), 887-900.
Rogers, J. G., Aaronson, K. D., Boyle, A. J., Russell, S. D., Milano, C. A., Pagani, F. D., . . . Conte, J. V. (2010). Continuous flow left ventricular assist device improves functional capacity and quality of life of advanced heart failure patients. Journal of the American College of Cardiology, 55(17), 1826-1834.
Rosca, E., Arnold, M., & Bendul, J. C. (2017). Business models for sustainable innovation–an empirical analysis of frugal products and services. Journal of Cleaner Production, 162, S133-S145.
Saleem, A., Ghafar, A., Ibrahim, M., Yousuf, M., & Ahmed, N. (2015). Product perceived quality and purchase intention with consumer satisfaction. Global journal of management and business research.
Simula, H., Hossain, M., & Halme, M. (2015). Frugal and reverse innovations–Quo Vadis? Current science, 1567-1572.
Snoj, B., Pisnik Korda, A., & Mumel, D. (2004). The relationships among perceived quality, perceived risk and perceived product value. Journal of Product & Brand Management, 13(3), 156-167.
Teece, D. J. (2010). Business models, business strategy and innovation. Long range planning, 43(2-3), 172-194.
Thakur, R., Hsu, S. H., & Fontenot, G. (2012). Innovation in healthcare: Issues and future trends. Journal of Business Research, 65(4), 562-569.
Tiwari, R., Kalogerakis, K., & Herstatt, C. (2014). Frugal innovation and analogies: some propositions for product development in emerging economies.
Tzeng, G.-H., Chiang, C.-H., & Li, C.-W. (2007). Evaluating intertwined effects in e-learning programs: A novel hybrid MCDM model based on factor analysis and DEMATEL. Expert Systems with Applications, 32(4), 1028-1044.
Winterhalter, S., Zeschky, M. B., Neumann, L., & Gassmann, O. (2017). Business models for frugal innovation in emerging markets: the case of the medical device and laboratory equipment industry. Technovation, 66, 3-13.
Wu, W.-W. (2008). Choosing knowledge management strategies by using a combined ANP and DEMATEL approach. Expert Systems with Applications, 35(3), 828-835.
Zeschky, M., Widenmayer, B., & Gassmann, O. (2014). Organising for reverse innovation in Western MNCs: the role of frugal product innovation capabilities. International Journal of Technology Management, 64(2-4), 255-275.
Zeschky, M. B., Winterhalter, S., & Gassmann, O. (2014). From cost to frugal and reverse innovation: Mapping the field and implications for global competitiveness. Research-Technology Management, 57(4), 20-27.
Zinsstag, J., Pelikan, K., Hammel, T., Tischler, J., Flahault, A., Utzinger, J., & Probst-Hensch, N. (2019). Reverse innovation in global health. Journal of Public Health and Emergency, 3.