Abstract
Innovation is hard to avoid, especially in healthcare. Even this issue of JRSM, which contains two articles concerned with innovation, has caught the bug.1,2 Innovation is the modern panacea. It will bring new products and novel approaches to clinicians and policy-makers. It will improve healthcare by delivering better quality care. Money is also a key theme here; indeed money and innovation seem to be inseparable. Successful innovations will save taxpayers' money while some of these innovations will make a few entrepreneurs and their financial backers unimaginably rich. There is a financial push and pull.
Still, innovation has many forms and several meanings. It might simply be a genius idea that requires support to make it reality. Another interpretation might be the ability of clinicians to be free of the bounds of ‘standard practice’, albeit in accordance with strict rules. Maurice Saatchi explains why his parliamentary bill to permit this particular form of innovation, focused on cancer care, is required and the arguments that he believes make it compelling. 1
The challenge for medical journals is how to capture innovation. Innovation, by dictionary definition, is ‘something new which is introduced, a new idea or a method’. The problem is that medical journals, as much as they seek to, tend to struggle to present genuinely new ideas or methods.
By the time a randomized controlled trial is published, the idea or the method is no longer new; the innovatory phase has passed or reached a late stage. Yet, medical journals do not have established means of presenting the exciting early phase of innovation, which is unlikely to have been assessed by a randomized controlled trial, the gold standard methodology to evaluate any new intervention.
Some journals publish research letters, short papers or pilot studies. But none of these solutions is sufficient to capture the broad range of innovation in healthcare, from new products to new services. If we accept the inextricable link between innovation and costs, for example, how should a report capture the efficiency savings in a convincing way without embarking on a full economic analysis? There is no quick solution, which is why medical journals are a no entry zone for innovation.
Other journals have grappled with this challenge and failed. But it is a challenge that JRSM is willing to take on. Over the coming months we will consult with our editorial board and experts in innovation to devise a way of presenting assessments of new innovations in healthcare. Like others, we might fail, but we will not fear failure, for every successful innovation there will be several thousand that flounder.
Failure, by some accounts, is the new success; innovation, for its part, is the new panacea.