When Selecting Health Innovations, Think Exothermic

Dr. Alison Paprica is Adjunct Faculty, IHPME and Principal, Research Project Management (RPM).  She also serves as Director, Strategic Partnerships at the Institute for Clinical Evaluative Sciences (ICES) where she facilitates and coordinates new and emerging ICES partnerships including the work with Health Quality Ontario, Cancer Care Ontario, the private sector, and the nascent Pan-Canadian Real-world Health Data Network.  From 2010 to 2013, she was the Director of the Planning, Research & Analysis Branch at the Ontario Ministry of Health & Long-Term Care.  Dr. Paprica has also held the positions of founding Manager of the Planning Unit at the Ministry of Health & Long-Term Care, Manager of Performance Measurement & Results at the Ministry of Research & Innovation, and Executive Assistant to the Deputy Minister of the Ministry of Economic Development & Trade.  Prior to joining the Ontario public service in 2001, she worked in international pharmaceutical R&D for seven years.  Alison has a PhD in organic chemistry from the University of Western Ontario and was a fellow in the Canadian Foundation for Healthcare Improvement EXTRA program from 2011 to 2013.

Innovations for complex systems often involve multiple actors and incorporate pre-existing assets. These complex approaches to selecting innovations both challenge and facilitate achieving consensus.  For example, increasing the diversity of actors and the heuristics they espouse can be beneficial to identifying potential solutions to a problem, or responses to an opportunity.  This seminar offers a heuristic from the field of chemistry can be used to help select innovations.  Thermodynamics teaches us that all reactions require “activation energy” to get started and that there are two major categories of reactions subsequent to that initial energy input.  Exothermic reactions, like burning wood, are energy releasing.  The heat that begins in a single match can spread to create a bonfire.  Endothermic reactions, like making synthetic diamonds, are energy consuming.  The moment the external energy input is withdrawn from an endothermic reaction, it stops.  Innovators should pay attention to whether the innovation they are considering will be net energy releasing and self-perpetuating (exothermic) vs. energy consuming (endothermic).  The most sustainable innovations will be those that are exothermic from the perspectives of multiple actors.  Clinical and policy examples will be presented that show how this chemistry heuristic can be used to retrospectively and prospectively assign labels to clinical and policy innovations.

Dr. Paprica’s Recommended Readings:

• Page SE. The difference: How the power of diversity creates better groups, firms, schools, and societies. Princeton University Press; 2008 Aug 11.  Subset of content available through: Hong L,
• Page SE. Groups of diverse problem solvers can outperform groups of high-ability problem solvers. Proceedings of the National Academy of Sciences of the United States of America. 2004 Nov 16;101(46):16385-9 http://www.pnas.org/content/101/46/16385.full
• Paprica PA, Culyer AJ, Elshaug AG, Peffer J, Sandoval GA. From talk to action: policy stakeholders, appropriateness, and selective disinvestment. Int J Technol Assess Health Care. 2015.  DOI: http://dx.doi.org/10.1017/S0266462315000392
• Heifetz RA, Linsky M. Leadership on the line: Staying alive through the dangers of leading. Harvard Business Press; 2002.  Subset of content related to adaptive vs. technical challenges at www.ucsummit.org/announce/Staff/…/Heifetz.docx
• Ontario Ministry of Health and Long-Term Care. Externally Informed Annual Health Systems Trends Report – 3rd Edition. 2010. 

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